Provider Demographics
NPI:1992020507
Name:POULIOT, JAMIE ELLEN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ELLEN
Last Name:POULIOT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 OLD HOMESTEAD HWY
Mailing Address - Street 2:SUITE I
Mailing Address - City:SWANZEY
Mailing Address - State:NH
Mailing Address - Zip Code:03446-2140
Mailing Address - Country:US
Mailing Address - Phone:603-209-6137
Mailing Address - Fax:
Practice Address - Street 1:217 OLD HOMESTEAD HWY
Practice Address - Street 2:SUITE I
Practice Address - City:SWANZEY
Practice Address - State:NH
Practice Address - Zip Code:03446-2140
Practice Address - Country:US
Practice Address - Phone:603-209-6137
Practice Address - Fax:603-499-4455
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7641101YM0800X
NH1001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health