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General NPI Number Information
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NPI Number | 1326673526
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Entity Type | Individual
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Provider Name | NATASHA REGINA PORTER PHD, LMFT, LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 11/12/2022
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Provider Practice Location Address
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Address Line | 300 W DIXIE AVE STE 11
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-1764
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Country | US
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Telephone | 270-900-1358
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Fax | 844-444-1150
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Provider Business Mailing Address
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Address Line | 300 W DIXIE AVE STE 11
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-1764
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Country | US
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Telephone | 270-900-1358
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Fax | 844-444-1150
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT4317
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 247969
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F2100220
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 262289
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License Number State | KY
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