Provider Demographics
NPI:1699822858
Name:PORRECA, RITA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:PORRECA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LATTICE LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3375
Mailing Address - Country:US
Mailing Address - Phone:610-831-5699
Mailing Address - Fax:
Practice Address - Street 1:1100 W VALLEY RD
Practice Address - Street 2:SUITE 5
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1447
Practice Address - Country:US
Practice Address - Phone:610-687-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000481106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist