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Dr. Jeremy Wayne Stout, PHD
Student in an Organized Health Care Education/Training Program in Richmond, Virginia
NPI 1003370321

Jeremy Wayne Stout is a Student in an Organized Health Care Education/Training Program based in Milford, VA. Jeremy Wayne Stout practices in Richmond, VA and has the professional credentials of PHD. The NPI Number for Jeremy Wayne Stout is 1003370321 and holds a License No. PY10800 (Virginia).

The current practice location address for Jeremy Wayne Stout is 1207 Broad Rock Blvd, Richmond, VA and can be reached out via phone at 804-675-5000.

Location: 1207 Broad Rock Blvd, Richmond, VA, 06461-1899
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003370321
Provider Name
Jeremy Wayne Stout
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
1207 Broad Rock Blvd, Richmond, VA, 06461-1899
Phone Number
804-675-5000
Fax Number
Provider Enumeration Date
01/31/2019
Last Update Date
04/13/2024
institution
Provider Business Practice Location Address Details
Address
1207 Broad Rock Blvd
City
Richmond
State
Virginia
Zip
23249-1899
Phone Number
804-675-5000
Fax Number
person
Provider Business Mailing Address Details
Address
1207 Broad Rock Blvd
City
Richmond
State
Virginia
Zip
23249-1899
Phone Number
804-675-5000
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
()
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
PY10800 (Florida)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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