Provider Demographics
NPI:1073234860
Name:GOULET, RILEY (LCSW)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:GOULET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-2333
Mailing Address - Country:US
Mailing Address - Phone:774-275-7853
Mailing Address - Fax:
Practice Address - Street 1:42 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-6400
Practice Address - Country:US
Practice Address - Phone:401-846-1213
Practice Address - Fax:401-848-6398
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW033781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical