Provider Demographics
NPI:1093187882
Name:STOUGH, LORAN (MSW)
Entity Type:Individual
Prefix:MISS
First Name:LORAN
Middle Name:
Last Name:STOUGH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:LORAN
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:659 S HAMPTON AT WATERFORD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-7862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:659 S HAMPTON AT WATERFORD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-7862
Practice Address - Country:US
Practice Address - Phone:717-880-6273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASWK132132104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker