Provider Demographics
NPI:1760413199
Name:SLAVIT, MICHAEL R (PH D)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:SLAVIT
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 NICHOL AVENUE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-919-6228
Mailing Address - Fax:401-884-2075
Practice Address - Street 1:3970 POST ROAD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-919-6228
Practice Address - Fax:401-884-2075
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00306103T00000X
RI00306103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI6148749OtherUNITED BEHAVIORAL GE
RI6148749OtherUBGE
RI23387-1OtherBLUE CROSS BLUE SHIELD
RI05-0468084OtherUNITED HEALTH PLANS
RI406638OtherCOORDINATED HEALTH CARE P