Bennett Steven Slotnick, PH D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS921 Issued in ME

Practice address

10 Storer St
Kennebunk, ME 04043-6875

Phone

(207) 467-8215

Fax

(207) 604-5024

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 9

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1972649689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OCEAN AVE",
            "address_2": "PO BOX 310",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040642407",
            "telephone_number": "207-934-5858",
            "fax_number": "207-934-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STORER ST",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436875",
            "telephone_number": "207-467-8215",
            "fax_number": "207-604-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOTNICK",
        "first_name": "BENNETT",
        "middle_name": "STEVEN",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "1718",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "310",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ME",
            "license": "PS921",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS921",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "1718",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "310",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "ME",
            "license": "PS921",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "1718",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NH",
            "license": "310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294560099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan P Shill, MD,PHD
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• Alexandra Sinsmyr, LMSW-CC
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• Zoe Rose Smallidge, LMSW-CC
• Dionne Smith
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• SMMC Visiting Nurses
• SMMC Visiting Nurses

• Clinical Neuropsychologist in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Clinical Neuropsychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.