Steffen Glenn Gillom, PHD, LMFT
Individual provider Active NPI Marriage & Family Therapist · Pawtucket, RI
NPI 1992670913 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1992670913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFT00316 (RI)
- Practice address
- 750 East Ave Unit 27
Pawtucket, RI 02860-6245 - Phone
- (401) 310-3856
- NPI assigned
- Oct 8, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 24, 2026 through Mar 24, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT00316 | RI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Goodwell Practice LLC | Marriage & Family Therapist | Current | Accepting new patients |
| Cumberland Counseling, LLC | Marriage & Family Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT00316 | RI | Yes |
Addresses
Primary practice location
750 East Ave Unit 27
Pawtucket, RI 02860-6245
Mailing address
750 East Ave Unit 27
Pawtucket, RI 02860-6245
Phone (401) 310-3856
Other providers in Pawtucket, RI
- Mohsen Gharavi
- Abbas Ghorieshi
- Melanie April Giglietti
- Elise Gilbert-Hall
- Peter S. Gill
- Maureen Giordano
- Laurice Girouard
- Aidan Glass
- Michael Glassman
- Glenn S. Prescod, M.D., M.P.H., Inc.
All providers in Pawtucket, RI · Marriage & Family Therapist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. 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.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.