Provider Demographics
NPI:1477188068
Name:POULIN, LINDSEY (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:POULIN
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 1:58 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-5501
Mailing Address - Country:US
Mailing Address - Phone:774-633-5274
Mailing Address - Fax:
Practice Address - Street 1:116 BELMONT STREET
Practice Address - Street 2:SUITE 31
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-0160
Practice Address - Country:US
Practice Address - Phone:774-633-5274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2251211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical