Provider Demographics
NPI:1033951470
Name:PORTER, JANEL MARIETTE (LMFT, ADC)
Entity type:Individual
Prefix:
First Name:JANEL
Middle Name:MARIETTE
Last Name:PORTER
Suffix:
Gender:F
Credentials:LMFT, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029B AIRPORT BLVD # 164
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-1366
Mailing Address - Country:US
Mailing Address - Phone:251-202-3090
Mailing Address - Fax:
Practice Address - Street 1:2029B AIRPORT BLVD # 164
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-1366
Practice Address - Country:US
Practice Address - Phone:251-202-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL653106H00000X
AL972101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)