Provider Demographics
NPI:1780191700
Name:PORTER, ABBEY FITCH (MS, EDS)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:FITCH
Last Name:PORTER
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2038
Mailing Address - Country:US
Mailing Address - Phone:917-684-1688
Mailing Address - Fax:
Practice Address - Street 1:170 HARPETH VIEW TRL
Practice Address - Street 2:
Practice Address - City:KINGSTON SPRINGS
Practice Address - State:TN
Practice Address - Zip Code:37082-9004
Practice Address - Country:US
Practice Address - Phone:615-952-2293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC213555101YM0800X
TN6652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health