Steffani Lynne Pouliot, LICSW
Individual provider Active NPI Clinical Social Worker · Hathorne, MA
NPI 1679964183 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1679964183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 123196 (MA)
- Practice address
- PO Box 93
Hathorne, MA 01937-0193 - Phone
- (315) 247-1589
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123196 | MA | MD | Mental Health Counselor |
| 5067 | NH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eliot Community Human Services | Current |
Accepting new patients | |
| Eliot Community Human Services | Current | Accepting new patients | |
| Healing Hope Supervision and Emdr Consultation LLC | Clinical | Current | Accepting new patients |
| Vitruvian Behavioral Health, PC | Mental Health | Past | Accepting new patients |
Locations
10 Harbor St
Danvers, MA 01923
Phone (978) 406-4164
173 Chelsea St
Everett, MA 02149
Phone (617) 397-2020
125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 123196 | MA | |
| Clinical Social Worker | 1041C0700X | 5067 | NH | |
| Clinical Social Worker | 1041C0700X | 123196 | MA | Yes |
Addresses
Primary practice location
PO Box 93
Hathorne, MA 01937-0193
Mailing address
100 Pleasant St
Marblehead, MA 01945-3398
Phone (315) 247-1589
Other practice location 1
100 Pleasant St
Marblehead, MA 01945-3398
Phone (315) 247-1589
Other practice location 2
100 Cummings Ctr Ste 207P
Beverly, MA 01915-6104
Phone (978) 791-3878
Other providers in Hathorne, MA
- Debra Beth Deflumeri
- Debra Dunham
- Essex North Shore Agricultural & Technical School District
- Steven N Goldberg
- Sandra L Goldstein Savoie
- Trustees of Tufts University
- Joanne Ventola
All providers in Hathorne, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.