Individual provider · Type 1 NPI

Stacie Lyn Souza, LICSW

Mental Health Counselor · Providence, RI

NPI number 1629188909 Active

Practice location

830 Chalkstone Ave
Providence, RI 02908-4734

Call (401) 273-7100 Map

Mailing address

12 Little John Ln
West Warwick, RI 02893-5593

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XCSW00735 (RI)

Mental Health Counselor: Definition to come...

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About NPI 1629188909

Stacie Lyn Souza, LICSW's National Provider Identifier is 1629188909, issued on Aug 30, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Providence, RI. The record was last updated on Jul 8, 2007.