Phyliss D. Stout, LCSW

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

1592C Issued in AL

Practice address

300 Gault Ave S
Fort Payne, AL 35967-1824

Phone

(256) 997-9356

Fax

(256) 997-9314

NPI assigned

Jan 22, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Life Center, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Fort Payne, AL
  • NPI 1740334358

  Adult Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073667622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GAULT AVE S",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671824",
            "telephone_number": "256-997-9356",
            "fax_number": "256-997-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GAULT AVE S",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359671824",
            "telephone_number": "256-997-9356",
            "fax_number": "256-997-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "PHYLISS",
        "middle_name": "D.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AL",
            "license": "1592C",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AL",
            "license": "1592C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL PROVIDER #",
            "identifier": "51553422STO",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51553422",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Stephens, CRNP
• Selena Stewart, LMSW
• Carolyn Fay Brewer Stiefel, C.R.N.P
• Dale Ray Stierwalt, MD
• Robert Mike Story, M.D.
• David Dillon Strange, DPT
• Peter Strogov, M.D.
• Haiyden Faith Stubblefield
• Luke Mackenzie Sullivan
• John Henry Sunderman

• Adolescent and Children Mental Health Clinic/Center in Fort Payne, AL
• Providers in Fort Payne, AL by specialty
• Adolescent and Children Mental Health Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.