Provider Demographics
NPI:1194883215
Name:CLOUTIER, LINDA (LMFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CLOUTIER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LINDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5712
Mailing Address - Country:US
Mailing Address - Phone:401-331-1350
Mailing Address - Fax:401-277-3366
Practice Address - Street 1:650 TEN ROD RD UNIT 13
Practice Address - Street 2:FAMILY SERIVCE OF RHODE ISLAND
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4237
Practice Address - Country:US
Practice Address - Phone:401-331-1350
Practice Address - Fax:401-277-3366
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT00074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILC34715Medicaid
1021740OtherNHP GROUP NUMBER