1568995249 NPI number — CHRISTOPHER JASON PORTER MS, LMHC, MHP, NCC

NPI Number: 1568995249
Health Care Provider/Practitioner: CHRISTOPHER JASON PORTER MS, LMHC, MHP, NCC

NPI Number : 1568995249 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568995249",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORTER",
    "FirstName": "CHRISTOPHER",
    "MiddleName": "JASON",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, LMHC, MHP, NCC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 657",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LANGLEY",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98260-0657",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "509-795-0518",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "115 2ND ST UNIT 657",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANGLEY",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98260-1925",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-795-0518",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/10/2017",
    "LastUpdateDate": "11/07/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "MC60791160",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "LH60999120",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "MC60791160",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}