Provider Demographics
NPI:1841030459
Name:PORTER, STEPHEN FRANCIS (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:FRANCIS
Last Name:PORTER
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 VINTAGE GREEN LN UNIT 1204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-4170
Mailing Address - Country:US
Mailing Address - Phone:312-810-2041
Mailing Address - Fax:
Practice Address - Street 1:1585 MALLORY LN STE 208
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3035
Practice Address - Country:US
Practice Address - Phone:615-235-5330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional