Provider Demographics
NPI:1568117406
Name:PORTERFIELD, ROBERT PEYTON (MA, LPC-A)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PEYTON
Last Name:PORTERFIELD
Suffix:
Gender:M
Credentials:MA, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 NORTH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-5018
Mailing Address - Country:US
Mailing Address - Phone:936-244-5681
Mailing Address - Fax:
Practice Address - Street 1:320 NORTH ST STE 201
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5018
Practice Address - Country:US
Practice Address - Phone:936-244-5681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88124101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health