Provider Demographics
NPI:1194407304
Name:STOUT, RACHEL (LPC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:STOUT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3032
Mailing Address - Country:US
Mailing Address - Phone:717-609-5443
Mailing Address - Fax:
Practice Address - Street 1:2401 PENNSYLVANIA AVE STE 1C44-45
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3010
Practice Address - Country:US
Practice Address - Phone:215-222-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014120101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health