Provider Demographics
NPI:1548398886
Name:PORTER, ANNE (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:ANNE
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N WEBER ST
Mailing Address - Street 2:#202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-5927
Mailing Address - Country:US
Mailing Address - Phone:719-635-6449
Mailing Address - Fax:719-475-0727
Practice Address - Street 1:801 N WEBER ST
Practice Address - Street 2:#202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5927
Practice Address - Country:US
Practice Address - Phone:719-635-6449
Practice Address - Fax:719-475-0727
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health