Provider Demographics
NPI:1912926684
Name:GIROUARD, LAURICE (LICSW)
Entity Type:Individual
Prefix:
First Name:LAURICE
Middle Name:
Last Name:GIROUARD
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:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:RI
Mailing Address - Zip Code:02802-0406
Mailing Address - Country:US
Mailing Address - Phone:401-334-0178
Mailing Address - Fax:
Practice Address - Street 1:42 PARK PL
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4010
Practice Address - Country:US
Practice Address - Phone:401-729-0080
Practice Address - Fax:401-729-0438
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW011761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILG58769Medicaid
RIP66541Medicare UPIN
RILG58769Medicaid