Shana Stout

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401018911 Issued in MI

Practice address

1608 Lake St
Kalamazoo, MI 49001-3170

Phone

(269) 344-0202

Fax

(269) 344-0285

NPI assigned

Aug 12, 2020

Last updated

Jan 22, 2021By 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 1

Addresses

Other names 1

• Shana Tubbs Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Restorative Therapy and Counseling ServicesGroup PAC ID 5193114635, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Restorative Therapy & Counseling Services

  • Clinical Social Worker
  • Portage, MI
  • NPI 1962005629
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1255942306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 LAKE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013170",
            "telephone_number": "269-344-0202",
            "fax_number": "269-344-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 LAKE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490013170",
            "telephone_number": "269-344-0202",
            "fax_number": "269-344-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "SHANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "TUBBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jocelyn Story
• Leslie Story, NP-C
• Nikki Lynn Story, DPT
• Grace Elizabeth Stouffer, RBT
• Alison M Stoughton, CFNP
• Shannon Stout
• Iesha Stovall-Atkins
• Jennifer Lynn Stover, LMSW
• Julie Stover
• Daniel Stowe, LLMSW

• Professional Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.