Provider Demographics
NPI:1093410292
Name:POIRIER, STAMATIA LAINAS (LICSW)
Entity Type:Individual
Prefix:
First Name:STAMATIA
Middle Name:LAINAS
Last Name:POIRIER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 DUNFEY ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-2320
Mailing Address - Country:US
Mailing Address - Phone:978-853-0078
Mailing Address - Fax:
Practice Address - Street 1:18 DUNFEY ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-2320
Practice Address - Country:US
Practice Address - Phone:978-853-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA125643101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor