Provider Demographics
NPI:1891224416
Name:PORTER, CAYSI (LMSW)
Entity Type:Individual
Prefix:
First Name:CAYSI
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-0175
Mailing Address - Country:US
Mailing Address - Phone:641-572-0721
Mailing Address - Fax:
Practice Address - Street 1:204 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1520
Practice Address - Country:US
Practice Address - Phone:641-572-0721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0860011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical