person
Mrs. Phyliss D. Stout, LCSW
Adolescent and Children Mental Health Clinic/Center in Fort Payne, Alabama
NPI 1073667622

Phyliss D. Stout is an Adolescent and Children Mental Health Clinic/Center based in Fort Payne, AL and is specialized in Adolescent and Children Mental Health. Phyliss D. Stout practices in Fort Payne, AL and has the professional credentials of LCSW. The NPI Number for Phyliss D. Stout is 1073667622 and holds a License No. 1592C (Alabama).

The current practice location address for Phyliss D. Stout is 300 Gault Ave S, Fort Payne, AL and can be reached out via phone at 256-997-9356 and via fax at 256-997-9314. You can also correspond with Phyliss D. Stout through the mailing address at 300 GAULT AVE S, FORT PAYNE, AL - 35967-1824 (mailing address contact number: 256-997-9356).

Location: 300 Gault Ave S, Fort Payne, AL, 35967-1824
person
Provider Profile Details
NPI Number
1073667622
Provider Name
Phyliss D. Stout
Credential
LCSW
Provider Entity Type
Individual
Gender
Female
Address
300 Gault Ave S, Fort Payne, AL, 35967-1824
Phone Number
256-997-9356
Fax Number
256-997-9314
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
51553422 05 AL
51553422STO 01 AL BCBS OF AL PROVIDER #
institution
Provider Business Practice Location Address Details
Address
300 Gault Ave S
City
State
Zip
35967-1824
Phone Number
256-997-9356
Fax Number
256-997-9314
person
Provider Business Mailing Address Details
Address
300 Gault Ave S
City
State
Zip
35967-1824
Phone Number
256-997-9356
Fax Number
256-997-9314
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
1592C (Alabama)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
1592C (Alabama)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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