Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Souliere, LICSW

Individual provider Clinical Social Worker · NPI 1710576004

Justin Souliere, LICSW is a Clinical Social Worker in Providence, Rhode Island. Graduated from Boston University School of Medicine in 2020, 6 years ago. Practices with Rhode Island Hospital, a 428-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
6
Trained at
Boston University School of Medicine
Licensed in
RI
In the registry since
2021
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

164 Summit Ave
Providence, RI 02906-2853
Phone: (401) 793-2920
Fax: (401) 793-2859
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence ISW04046 (RI)

Record details

NPI number1710576004
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 12, 2021
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Rhode Island Hospital — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence