| Laura Gustafson Porter, PHD | |
|
7714 Conner Rd Ste 105, Powell, TN 37849-3559 | |
| (865) 947-6220 | |
| (865) 512-1069 |
| Full Name | Laura Gustafson Porter |
|---|---|
| Gender | Female |
| Speciality | Clinical Psychologist |
| Experience | 22 Years |
| Location | 7714 Conner Rd Ste 105, Powell, Tennessee |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720087901 | NPI | - | NPPES |
| 3981441 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2546(PROVISIONAL) (Tennessee) | Secondary |
| 103TC0700X | Psychologist - Clinical | P2546 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cherokee Health Systems | 3577474295 | 102 |
| Entity Name | Cherokee Health Systems |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134128820 PECOS PAC ID: 3577474295 Enrollment ID: O20031119000769 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Gustafson Porter, PHD 6350 W Andrew Johnson Hwy Dept 100, Talbott, TN 37877-8605 Ph: (800) 355-3565 | Laura Gustafson Porter, PHD 7714 Conner Rd Ste 105, Powell, TN 37849-3559 Ph: (865) 947-6220 |
Sara Haugli, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7714 Conner Rd, Suite 105, Powell, TN 37849 Phone: 865-947-6220 Fax: 865-512-1069 | |
William Allan Richards Jr., PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 7714 Conner Rd, Powell, TN 37849 Phone: 865-947-6220 Fax: 865-512-1069 | |
Mrs. Jessica L Allin, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 7714 Conner Rd, Suite 105, Powell, TN 37849 Phone: 865-947-6220 Fax: 865-512-1069 | |
Adair Allen, PH. D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7714 Conner Rd, Powell, TN 37849 Phone: 865-947-6220 Fax: 865-512-1069 |