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

Shalissa Rose Coutoulakis, LCSW

Individual provider Clinical Social Worker · NPI 1164058202

Shalissa Rose Coutoulakis, LCSW is a Clinical Social Worker in Pawtucket, Rhode Island. Practices as a sole proprietor. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2020
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

304 Beverage Hill Ave
Pawtucket, RI 02861-4462
Phone: (401) 484-3012
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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 CSW02399 (RI)

Record details

NPI number1164058202
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 20, 2020
Last updated in NPPESMarch 20, 2020
Certification dateMarch 20, 2020

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