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NPI Code Detail

MEDICARE: PHILIP W PORTER

MEDICARE: PHILIP W PORTER
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
1101YM0800XMental Health Counselor6536SC

General Provider Information

NPI Number : 1396930194
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP W PORTER
Provider Business Mailing Address
First Line : P.O. BOX 5158
Second Line :
City : SPARTANBURG
State : SC
Zip : 29304
Country : US
Telephone Number : 864-582-2411
Fax Number : 864-594-0040
Provider Business Practice Location Address
First Line : 460 LANGDON ST.
Second Line :
City : SPARTANBURG
State : SC
Zip : 29302-1614
Country : US
Telephone Number : 864-582-2411
Fax Number : 864-594-0040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2007
Last Update Date : 02/07/2023

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Directions to “ PHILIP W PORTER ” Practice Location

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