Healthcare Provider Details

I. General information

NPI: 1780908350
Provider Name (Legal Business Name): PORTER-STARKE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7403 CLINE AVE
SCHERERVILLE IN
46375-2645
US

IV. Provider business mailing address

601 WALL ST
VALPARAISO IN
46383-2512
US

V. Phone/Fax

Practice location:
  • Phone: 219-322-8614
  • Fax: 219-864-3179
Mailing address:
  • Phone: 219-531-3500
  • Fax: 219-462-3975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH ANN MITCHELL
Title or Position: THERAPIST
Credential: M.S., LMFT
Phone: 219-322-8614