Healthcare Provider Details

I. General information

NPI: 1225963101
Provider Name (Legal Business Name): LEONIE STOUTE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5022 CAMPBELL BLVD STE L-M
NOTTINGHAM MD
21236-4969
US

IV. Provider business mailing address

1300 YARDS PL SE
WASHINGTON DC
20003-6001
US

V. Phone/Fax

Practice location:
  • Phone: 443-442-1568
  • Fax:
Mailing address:
  • Phone: 347-789-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34858
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: