Stacie Lyn Souza, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CSW00735 Issued in RI

Practice address

830 Chalkstone Ave
Providence, RI 02908-4734

Phone

(401) 273-7100

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629188909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 LITTLE JOHN LN",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935593",
            "telephone_number": "401-273-7100",
            "fax_number": "401-525-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084734",
            "telephone_number": "401-273-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "STACIE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "CSW00735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Levon Souvalian, MD
• Joan A Souza, MSW LICSW
• Kelly Ann Souza
• Monica Katharine Souza, PA-C
• Nicholas Joseph Souza, LPN
• Victoria Souza, PHARMD
• Carole Suzanne Lucie Spake, MD
• Anthony Joseph Spallino, PA-C
• Lora Spalt, LCDS
• Partaja Niqua Spann Taylor, LCSW

• Mental Health Counselor in Providence, RI
• Providers in Providence, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.