MRS. PHYLISS D. STOUT LCSW NPI 1073667622

NPI Information

NPI: 1073667622
Provider Name: MRS. PHYLISS D. STOUT, LCSW
Classification: Clinic/Center - 261QM0850X
Entity Type: Individual

Specialization: Adult Mental Health

Address:
300 GAULT AVE S
FORT PAYNE, AL
ZIP 35967
Phone: (256) 997-9356
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MRS. Phyliss D. Stout, LCSW is an adult mental health clinic center in Fort Payne, AL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. MRS. Phyliss D. Stout, LCSW NPI is 1073667622. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

300 GAULT AVE S
FORT PAYNE, AL
ZIP 35967-824
Phone: (256) 997-9356
Fax: (256) 997-9314

The enumeration date for this NPI number is 1/22/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health	1592C	ALABAMA	Yes
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	1592C	ALABAMA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	51553422STO	OTHER	ALABAMA	BCBS OF AL PROVIDER #
2	P85793	MEDICARE UPIN	ALABAMA
3	51553422	MEDICAID	ALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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