KELLY STOUT (NPI# 1013395128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013395128 |
| Entity Type | Individual |
| Full Name | KELLY STOUT |
| Credential | PHD |
| Practice Address |
295 S Chipeta Way Salt Lake City UT 84108-1287 |
| Mailing Address |
127 S. 500 E Suite 600 Salt Lake City UT 84102-1971 |
| Practice Telephone | 8012133469 |
| Mailing Telephone | 8015876336 |
| Mailing Fax Number | 8017158228 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-08-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6022766-2501 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780072330 | Kelly Lynn Stout | Nurse Practitioner | 1471 Jag Branch Blvd Ste 101, Kernersville, NC 27284-6956 | 2015-01-06 |
| 1255673810 | Kelly Ann Stout | Social Worker | 2980 S Jones Blvd, Las Vegas, NV 89146-5656 | 2013-03-21 |
| 1154406007 | Kelly Ann Stout | Social Worker | 155 Inverness Dr W, Ste 200, Englewood, CO 80112-5095 | 2006-10-26 |
| 1083711881 | Kelly Best Stout | Pharmacist | 221 N Graham Hopedale Rd, Pharmacy, Burlington, NC 27217-2971 | 2006-09-20 |
| Street Address |
295 S CHIPETA WAY |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84108-1287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346248465 | Justin Charles Alvey | Pediatrics | 295 S Chipeta Way, University of Utah Department of Pediatrics, Salt Lake City, UT 84108-1287 | 2005-07-12 |
| 1912535501 | Margaret Jean Bale | Student in an Organized Health Care Education/Training Program | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2020-03-30 |
| 1376183582 | Claire Ann Goeke | Nurse Practitioner | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2020-01-15 |
| 1528544012 | Ashley Berrett | Dietitian, Registered | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2018-07-17 |
| 1588184105 | Samuel B. Zoucha | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-06-24 |
| 1114457413 | Adrienne Cohen | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-06-19 |
| 1447780119 | Christine Morris | Physician Assistant | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-06-15 |
| 1023545670 | Natalie Justine Tedford | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-05-15 |
| 1356876858 | Allison M. Fisher | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84132-1287 | 2017-04-22 |
| 1174056758 | Andrew Daniel Fontes | Pediatrics | 295 S Chipeta Way, Salt Lake City, UT 84108-1287 | 2017-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548753056 | Maxine Ht Erickson | Assistant Behavior Analyst | 780 Guardsman Way, Salt Lake City, Ut 84108, Salt Lake City, USA 84108 | 2018-06-08 |
| 1841704061 | Robyn Carver | Occupational Therapist | 421 Wakara Wat, Salt Lake City, UT 84108 | 2017-11-27 |
| 1518478742 | Lcr Dental Sugar House | Dentist | 2068 S 2100 E Suite #a, Salt Lake City, UT 84108 | 2017-10-16 |
| 1447708912 | Aubrianne Squire Evans | Occupational Therapist | 421 S Wakara Way Ste 201, Salt Lake City, UT 84108 | 2016-09-14 |
| 1629524426 | Ryan Weisenbeck | Specialist/Technologist | 580 S Guardsman Way, Salt Lake City, UT 84108 | 2016-08-31 |
| 1164885547 | Michael Fazzone | Student in an Organized Health Care Education/Training Program | 530 South Wakara Way, University of Urah, School of Dentistry, Salt Lake City, UT 84108 | 2016-04-01 |
| 1669833489 | Bryon Claflin | Registered Nurse | 650 S Komas Ste 200, Salt Lake City, UT 84108 | 2016-03-08 |
| 1801283833 | Autism Assement Treatment Program Adult | Psychologist | 650 S Komas, Suite 200, Salt Lake City, UT 84108 | 2015-04-16 |
| 1578993275 | Matthew and David Dental Pllc | Dentist | 1355 Foothill Drive, Salt Lake City, UT 84108 | 2013-11-15 |
| 1841631520 | Deepika Garg | Internal Medicine | 675 S Arapeen Dr Ste 205, Salt Lake City, UT 84108 | 2013-07-10 |
| Find all providers in zip 84108 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346857026 | Adam Hanley | Psychologist | 395 S 1500 E, Salt Lake City, UT 84112-8909 | 2020-09-28 |
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1184199721 | Aharon D. Shulimson, Ph.d. | Psychologist | 1111 E Brickyard Rd Ste 205, Salt Lake City, UT 84106-2571 | 2018-10-10 |
| 1437666054 | Novum Psychotherapy, PC | Psychologist | 275 E South Temple Ste 150, Salt Lake City, UT 84111-1270 | 2018-01-04 |
| 1952812414 | Lauren Michele Weitzman | Psychologist | 24 S 1100 E Ste 303, Salt Lake City, UT 84102-4307 | 2017-10-23 |
| 1326565300 | James Knorr | Psychologist | 7069 S Highland Dr Ste 5, Salt Lake City, UT 84121-3724 | 2017-08-29 |
| 1043735418 | Christopher M Davids | Psychologist | 439 E 900 S Fl 2, Salt Lake City, UT 84111-4303 | 2017-08-07 |
| 1710416037 | Lori Lynn Dekeyzer | Psychologist | 4568 S Highland Dr Ste 200, Salt Lake City, UT 84117-4235 | 2017-06-08 |
| 1285178459 | Mountain West Evaluation & Therapy Services | Psychologist | 3344 S 1885 E, Salt Lake City, UT 84106-3942 | 2016-12-07 |
| 1194270876 | Gita Rakhsha, Ph.d. LLC | Psychologist | 2046 E Murray Holladay Rd Ste 103, Salt Lake City, UT 84117-5175 | 2016-08-23 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84108 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.