Provider Demographics
NPI:1255706412
Name:PORCHIA, RONNIE (LPC)
Entity type:Individual
Prefix:
First Name:RONNIE
Middle Name:
Last Name:PORCHIA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63000 DARNALL LOOP
Mailing Address - Street 2:CARL R, DARNALL ARMY MEDICAL CENTER
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-4752
Mailing Address - Country:US
Mailing Address - Phone:334-322-6964
Mailing Address - Fax:
Practice Address - Street 1:63000 DARNALL LOOP
Practice Address - Street 2:CARL R, DARNALL ARMY MEDICAL CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-4752
Practice Address - Country:US
Practice Address - Phone:334-322-6964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional