Active NPI
Kerry L. Stout, LICSW
- Clinical Social Worker
- Essex Junction, VT
National Provider Identifier
1295983872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0890001258
- Practice address
- 15 Pinecrest Dr
Essex Junction, VT 05452-2912 - Phone
- (802) 288-1087
- Fax
- (802) 878-4404
- NPI assigned
- Sep 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0890001258 | VT | Primary |
Addresses
Primary practice location
15 Pinecrest Dr
Essex Junction, VT 05452-2912
Mailing address
208 Flynn Ave
3J
Burlington, VT 05401-5429
Phone (802) 488-6900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0890001258 | VT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1295983872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 FLYNN AVE",
"address_2": "3J",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015429",
"telephone_number": "802-488-6900",
"fax_number": "802-488-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PINECREST DR",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054522912",
"telephone_number": "802-288-1087",
"fax_number": "802-878-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "KERRY",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-08",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "0890001258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.