Provider Demographics
NPI:1124439823
Name:STOUT, MARISSA (MSW, BSL)
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:
Last Name:STOUT
Suffix:
Gender:F
Credentials:MSW, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5648 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3610
Mailing Address - Country:US
Mailing Address - Phone:412-661-1827
Mailing Address - Fax:412-661-1867
Practice Address - Street 1:5648 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3610
Practice Address - Country:US
Practice Address - Phone:412-661-1827
Practice Address - Fax:412-661-1867
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health