Provider Demographics
NPI:1447753652
Name:E. PORTER COUNSELING LCSW
Entity Type:Organization
Organization Name:E. PORTER COUNSELING LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:K
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:802-578-4487
Mailing Address - Street 1:1305 CLARENDON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3538
Mailing Address - Country:US
Mailing Address - Phone:802-578-4487
Mailing Address - Fax:
Practice Address - Street 1:727 EASTOWNE DR STE 300B
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2298
Practice Address - Country:US
Practice Address - Phone:802-578-4487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC010443261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health