Provider Demographics
NPI:1538560297
Name:STOUT, RENEE R (MSW, LSW)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:R
Last Name:STOUT
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WOMELSDORF
Mailing Address - State:PA
Mailing Address - Zip Code:19567-1504
Mailing Address - Country:US
Mailing Address - Phone:610-780-1010
Mailing Address - Fax:
Practice Address - Street 1:640 WALNUT ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3504
Practice Address - Country:US
Practice Address - Phone:610-208-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132546104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker