Active NPI
Robert Lee Stough Jr., PH.D.
- Psychologist
- Walla Walla, WA
National Provider Identifier
1962442004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2938
- Practice address
- 409 E Sumach St
Walla Walla, WA 99362-1228 - Phone
- (509) 527-2943
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2938 | WA | Primary |
Addresses
Primary practice location
409 E Sumach St
Walla Walla, WA 99362-1228
Mailing address
PO Box 775
College Place, WA 99324-0775
Phone (509) 527-2943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050923000556 | WA | Practitioner - Clinical Psychologist | 2668406158 | Practice locations: Walla Walla, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2330 Eastgate St
Suite 215
Walla Walla, WA 99362-1559
Phone (509) 525-0708
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2938 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1962442004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 775",
"city": "COLLEGE PLACE",
"state": "WA",
"postal_code": "993240775",
"telephone_number": "509-527-2943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 E SUMACH ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993621228",
"telephone_number": "509-527-2943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUGH",
"first_name": "ROBERT",
"middle_name": "LEE",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "2938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.