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JACKIE L STOUT LCSW
NPI 1518280536
Social Worker - Clinical in Vienna, VA

Active since March 04, 2010Opted out of Medicare · through Jul 1, 2028
410 MAPLE AVE W, SUITE 7, VIENNA, VA 22180(703) 342-4671 Get Directions Write a Review

NPPES record last updated: March 4, 2010. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Jackie L Stout Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKIE L STOUT LCSW (NPI 1518280536) is an individual clinical provider in Vienna, Virginia, licensed in Virginia (0904007252) and active in the NPI registry since March 2010. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1518280536
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACKIE L STOUTCredential: LCSW
Location Address410 MAPLE AVE W, SUITE 7Vienna, VA 22180-4224
Mailing Address410 Maple Ave W, Suite 7Vienna, VA 22180-4224 · (703) 342-4671
Phone(703) 342-4671
Sole ProprietorNo
Enumeration DateMarch 4, 2010
✔ NPI 1518280536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in VA · 0904007252
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
410 MAPLE AVE W, Vienna, VA 22180
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jackie L Stout Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2014 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2014
Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22180 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $65.18 – $194.86
Typical copayment $0.00 (range $16.29 – $48.71)
Most-billed visit code NA
Established Patient
$80.66 typical visit price
range $21.40 – $158.88
Typical copayment $20.16 (range $5.35 – $39.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. PEGGY S THURSTON CPNP
Nurse Practitioner
410 MAPLE AVE W, 5
VIENNA, VA 22180
Fairfax County (703) 938-2244
MS. WENDY KAY SNYDER MS
Specialist
410 MAPLE AVE W, SUITE 7
VIENNA, VA 22180
Fairfax County (703) 281-9313
KANAKA SRIRAM, D.D.S., P.C.
Dentist (General Practice)
410 MAPLE AVE W, SUITE 2
VIENNA, VA 22180
Fairfax County (703) 255-2326
MR. AARON M LOPATA MD
Pediatrics
410 MAPLE AVE W, #5
VIENNA, VA 22180
Fairfax County (703) 932-2244
MR. WILLIAM MICHAEL CASSIDY MD
Pediatrics
410 MAPLE AVE W, 5
VIENNA, VA 22180
Fairfax County (703) 938-2244
VIRGINIA GYNECOLOGISTS, LTD
Obstetrics & Gynecology
410 MAPLE AVE W
VIENNA, VA 22180
Fairfax County (703) 281-5007

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Stout's NPI number?

The NPI number for Jackie Stout is 1518280536. It was assigned to this individual provider in the NPPES registry on March 4, 2010.

Where is Jackie Stout located?

Jackie Stout practices at 410 Maple Ave W Suite 7, Vienna, VA 22180. The listed phone number is (703) 342-4671.

What is Jackie Stout's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jackie Stout enrolled in Medicare?

No. Jackie Stout has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jackie Stout was last updated on March 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.