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General NPI Number Information
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NPI Number | 1447453758
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Entity Type | Individual
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Provider Name | SHARON STOUT L.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 8 GRANITE STATE CT COUNSELING SUITE
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City | BREWSTER
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State | MA
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Zip | 02631-2127
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Country | US
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Telephone | 774-722-4350
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Fax | 508-240-6521
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Provider Business Mailing Address
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Address Line | 8 GRANITE STATE COURT
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City | BREWSTER
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State | MA
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Zip | 02631-0107
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Country | US
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Telephone | 774-722-4350
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Fax | 508-240-6521
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1477
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License Number State | MA
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