Provider Demographics
NPI:1548592652
Name:STROUT, ANNA G (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:G
Last Name:STROUT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROBINHOOD RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-1815
Mailing Address - Country:US
Mailing Address - Phone:207-891-6534
Mailing Address - Fax:888-492-0305
Practice Address - Street 1:449 FOREST AVE STE 211
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2008
Practice Address - Country:US
Practice Address - Phone:207-891-6534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC63001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical