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NPI Code Detail

MEDICARE: DR. BECKY L. PORTER PH.D.

MEDICARE: DR. BECKY L. PORTER PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist83-6PAR
2103TB0200XCognitive & Behavioral Psychologist
3103TC2200XClinical Child & Adolescent Psychologist
4103TF0000XFamily Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
156367OTHERARABCBS
211475OTHERFLSUNBELT MEDICAL MGMT.

General Provider Information

NPI Number : 1255339461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BECKY L. PORTER PH.D.
Provider Business Mailing Address
First Line : 2024 ARKANSAS VALLEY DR
Second Line : SUITE 604
City : LITTLE ROCK
State : AR
Zip : 72212-4166
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2024 ARKANSAS VALLEY DR
Second Line : SUITE 604
City : LITTLE ROCK
State : AR
Zip : 72212-4166
Country : US
Telephone Number : 501-227-8555
Fax Number : 501-227-8566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 09/11/2025

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