Provider Demographics
NPI:1457077687
Name:STOUT, TAYLOR SHAYNE (LMSW)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SHAYNE
Last Name:STOUT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1134
Mailing Address - Country:US
Mailing Address - Phone:913-944-2076
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD STE 130
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2261
Practice Address - Country:US
Practice Address - Phone:316-394-0040
Practice Address - Fax:316-221-7139
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker