Provider Demographics
NPI:1023445533
Name:SLOTNICK, LEWIS ALAN (MS LADC ICAADC SAP)
Entity type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:ALAN
Last Name:SLOTNICK
Suffix:
Gender:M
Credentials:MS LADC ICAADC SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06013-1902
Mailing Address - Country:US
Mailing Address - Phone:860-324-6506
Mailing Address - Fax:
Practice Address - Street 1:73 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1923
Practice Address - Country:US
Practice Address - Phone:860-324-6506
Practice Address - Fax:860-675-6124
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-28
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000544101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor