Active NPI
Marianne Sevilla Stout, PHD
- Counseling Psychologist
- Austin, TX
National Provider Identifier
1316205172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 36011
- Practice address
- 8705 Shoal Creek Blvd
108
Austin, TX 78757-6802 - Phone
- (512) 436-3225
- NPI assigned
- Apr 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 36011 | TX | Primary |
Addresses
Primary practice location
8705 Shoal Creek Blvd
108
Austin, TX 78757-6802
Mailing address
5104 Woodview Ave
Austin, TX 78756-1905
Phone (512) 574-5854
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36011 | TX | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335744000000",
"number": "1316205172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5104 WOODVIEW AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787561905",
"telephone_number": "512-574-5854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8705 SHOAL CREEK BLVD",
"address_2": "108",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787576802",
"telephone_number": "512-436-3225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "MARIANNE",
"middle_name": "SEVILLA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-30",
"last_updated": "2012-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "36011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.