Stout, Phyliss D.
Stout, Phyliss D. is an sole proprietor health care provider with primary practice located at 300 Gault Ave S , Fort Payne AL 35967-1824. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Ambulatory Health Care Facilities / Adult Mental Health is her primary health care specialty. Stout, Phyliss D. can be contacted via phone (256) 997-9356.Contact Information
Primary practice address
300 Gault Ave S
Fort Payne AL 35967-1824
Phone: (256) 997-9356
Fax: (256) 997-9314
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X | 1592C | Alabama |
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X | 1592C | Alabama |
Profile Details
| NPI number | 1073667622 |
|---|---|
| LBN Legal business name | Stout, Phyliss D. |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073667622 | NPPES |
| Alabama | MEDICAID | 51553422 | |
| Alabama | Other | 51553422STO |
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