Provider Demographics
NPI:1942969423
Name:PORTER, FELESHIA ANN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:FELESHIA
Middle Name:ANN
Last Name:PORTER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13500 MIDWAY RD STE 404
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5154
Mailing Address - Country:US
Mailing Address - Phone:214-454-8144
Mailing Address - Fax:
Practice Address - Street 1:13500 MIDWAY RD STE 404
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5154
Practice Address - Country:US
Practice Address - Phone:214-454-8144
Practice Address - Fax:214-904-8222
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional