Logan Stout Therapy Services,LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LOGAN STOUT THERAPY SERVICES,LLC

Practice address

800 E Milham Ave Ste 200
Portage, MI 49002-1490

Phone

(269) 744-4725

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Logan T Stout, LMSWNPI 1437699659

Title

Owner

Phone

(269) 744-4725

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Logan Stout

  • Clinical Social Worker
  • Paw Paw, MI
  • NPI 1437699659
  NPD Authorized official

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1508459942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E MILHAM AVE STE 200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021490",
            "telephone_number": "269-744-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E MILHAM AVE STE 200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021490",
            "telephone_number": "269-744-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN STOUT THERAPY SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-744-4725",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Dawn Liskovec, RN
• Brian Nathaniel Little
• Living Well Chiropractic Center (Living Well Chiropractic)
• Alexandra Locke
• Jayla Lockhart
• Kailee Logan
• Kamille Logan
• McKenzie Logan
• Randi Loggains
• Ava Loncharte

• Clinical Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.