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General NPI Number Information
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NPI Number | 1013395326
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Entity Type | Individual
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Provider Name | ELIZABETH PORFERT LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 10033 WINDING RIVER RD
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City | PUNTA GORDA
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State | FL
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Zip | 33950-1302
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Country | US
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Telephone | 239-284-7164
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Fax |
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Provider Business Mailing Address
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Address Line | 10033 WINDING RIVER RD
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City | PUNTA GORDA
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State | FL
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Zip | 33950-1302
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Country | US
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Telephone | 239-284-7164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LMHC10001296
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License Number State | MA
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