Provider Demographics
NPI:1669621934
Name:STOUT, PAULINA H (LCSW)
Entity type:Individual
Prefix:
First Name:PAULINA
Middle Name:H
Last Name:STOUT
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 1:6 SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-2415
Mailing Address - Country:US
Mailing Address - Phone:781-698-6647
Mailing Address - Fax:
Practice Address - Street 1:6 SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-2415
Practice Address - Country:US
Practice Address - Phone:781-698-6647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2151531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical