Provider Demographics
NPI:1568223964
Name:PORTER, SARAH (MA, RMHCI)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:MA, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8922 HAVASU DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8531
Mailing Address - Country:US
Mailing Address - Phone:132-194-6317
Mailing Address - Fax:
Practice Address - Street 1:8922 HAVASU DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8531
Practice Address - Country:US
Practice Address - Phone:321-946-3178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health