Provider Demographics
NPI:1811348154
Name:PORTER, JONATHAN (LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:PORTER
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 WORTHAM CENTER DR FL 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5625
Mailing Address - Country:US
Mailing Address - Phone:281-617-9487
Mailing Address - Fax:
Practice Address - Street 1:13100 WORTHAM CENTER DR FL 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5625
Practice Address - Country:US
Practice Address - Phone:281-617-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2023-01-19
Deactivation Date:2022-02-26
Deactivation Code:
Reactivation Date:2022-03-22
Provider Licenses
StateLicense IDTaxonomies
LA6000101YM0800X
TX88515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health