Healthcare Provider Details

I. General information

NPI: 1902710833
Provider Name (Legal Business Name): LEAH PORCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 PACES FERRY RD SE STE 500
ATLANTA GA
30339-4053
US

IV. Provider business mailing address

3375 SPRING HILL PKWY SE APT 1527
SMYRNA GA
30080-6859
US

V. Phone/Fax

Practice location:
  • Phone: 404-991-2638
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: