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1790007839 NPI number — PATRICIA MAE PORTER LCSW

NPI Number: 1790007839
Health Care Provider/Practitioner: PATRICIA MAE PORTER LCSW

Information about “1790007839” NPI (PATRICIA MAE PORTER LCSW) exists in 1790007839 in HTML format HTML  |  1790007839 in plain Text format TXT  |  1790007839 in PDF (Portable Document Format) PDF  |  1790007839 in an XML format XML  formats.

NPI Number : 1790007839 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790007839",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PORTER",
    "FirstName": "PATRICIA",
    "MiddleName": "MAE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LCSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "13407 POSSUM ROCK",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN ANTONIO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "78232-4763",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "210-880-4440",
    "MailingAddressFaxNumber": "260-572-3757",
    "FirstLinePracticeLocationAddress": "13407 POSSUM ROCK",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN ANTONIO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "78232-4763",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "210-880-4440",
    "PracticeLocationAddressFaxNumber": "260-572-3757",
    "EnumerationDate": "02/16/2010",
    "LastUpdateDate": "02/16/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "42026",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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