Provider Demographics
NPI:1497863708
Name:STOUTER, LAWRENCE R (LCPC)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:R
Last Name:STOUTER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:R
Other - Last Name:STOUTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:228 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5721
Mailing Address - Country:US
Mailing Address - Phone:301-745-6687
Mailing Address - Fax:301-739-0041
Practice Address - Street 1:228 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5721
Practice Address - Country:US
Practice Address - Phone:301-745-6687
Practice Address - Fax:301-739-0041
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
2235173OtherPHCS
178977OtherCOMPSYCH
MDT5150001OtherCAREFIRST BCBS - NCA
5482516OtherAETNA (CCC)
1992391OtherUHC
452936OtherVALUE OPTIONS
2052870OtherCIGNA
0X38CAOtherCAREFIRST BCBS