| Dwight A Porter, LPC | |
|
4405 Mall Blvd, Suite 200, Union City, GA 30291-2044 | |
| (770) 969-4309 | |
| (770) 969-4170 |
| Full Name | Dwight A Porter |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 4405 Mall Blvd, Union City, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194158220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 006366 (Georgia) | Primary |
| Entity Name | Chesterfield Family Guidance Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225192909 PECOS PAC ID: 5799762712 Enrollment ID: O20040707000513 |
| Mailing Address | Practice Location Address |
|---|---|
| Dwight A Porter, LPC 4405 Mall Blvd, Suite 200, Union City, GA 30291-2044 Ph: (770) 969-4309 | Dwight A Porter, LPC 4405 Mall Blvd, Suite 200, Union City, GA 30291-2044 Ph: (770) 969-4309 |
Jarvis Lionel Howard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4405 Mall Blvd, Union City, GA 30291 Phone: 770-756-6495 | |
Courtney Willis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 Mumsford Ct, Union City, GA 30291 Phone: 404-642-7565 | |
Naamau Tahiru, Counselor Medicare: Medicare Enrolled Practice Location: 7463 Toccoa Cir, Union City, GA 30291 Phone: 646-249-6070 | |
Sheila Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4405 Mall Blvd, Union City, GA 30291 Phone: 770-892-3200 | |
Dr. Maurita Marice Hodge, ED.D, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4637 Ravenwood Loop, Union City, GA 30291 Phone: 770-306-6127 Fax: 770-995-1959 | |
Karan Lawyer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4405 Mall Blvd Ste 310, Union City, GA 30291 Phone: 770-892-3200 |