| Courtney Porter Therapy, Llc | |
|
1801 Woodfield Dr # 212 Savoy IL 61874-9505 | |
| (217) 898-9131 | |
| Not Available |
| Full Name | Courtney Porter Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1801 Woodfield Dr # 212, Savoy, Illinois |
| Authorized Official Name and Position | Courtney Porter (OWNER) |
| Authorized Official Contact | 2178989131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courtney Porter Therapy, Llc 1801 Woodfield Dr # 212 Savoy IL 61874-9505 Ph: (217) 898-9131 | Courtney Porter Therapy, Llc 1801 Woodfield Dr # 212 Savoy IL 61874-9505 Ph: (217) 898-9131 |
| NPI Number | 1194549352 |
|---|---|
| Provider Enumeration Date | 11/13/2024 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 4385164219 |
|---|---|
| Medicare Enrollment ID | O20250224000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194549352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Courtney Ann Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265099790 PECOS PAC ID: 8426466525 Enrollment ID: I20210408001966 |
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