Provider Demographics
NPI:1972327799
Name:STOUT, EMMA SYDNEY (MA)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:SYDNEY
Last Name:STOUT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2197 NOLENSVILLE PIKE APT 128
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2098
Mailing Address - Country:US
Mailing Address - Phone:406-459-0568
Mailing Address - Fax:
Practice Address - Street 1:842 TYNE BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1505
Practice Address - Country:US
Practice Address - Phone:406-459-0568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health