Provider Demographics
NPI:1902185762
Name:OULETTE, BRIENNA (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIENNA
Middle Name:
Last Name:OULETTE
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 1:2024 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3424
Mailing Address - Country:US
Mailing Address - Phone:401-757-0206
Mailing Address - Fax:
Practice Address - Street 1:428 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4502
Practice Address - Country:US
Practice Address - Phone:828-213-4502
Practice Address - Fax:828-213-4540
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIC512101Y00000X
RICSW01442104100000X
RIISW024541041C0700X
NCC0112221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker