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General NPI Number Information
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NPI Number | 1407779648
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Entity Type | Individual
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Provider Name | STEPHANIE M PORTER LPC-T
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 550 N MAIN ST UNIT A
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City | SPRINGBORO
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State | OH
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Zip | 45066-7520
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Country | US
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Telephone | 937-741-8708
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Fax | 937-550-4619
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Provider Business Mailing Address
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Address Line | 509 N CLARIDGE DR
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City | KETTERING
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State | OH
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Zip | 45429-1553
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Country | US
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Telephone | 937-741-8708
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Fax | 937-550-4619
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | C.2607999-TRNE
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License Number State | OH
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