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NPI Code Detail

MEDICARE: REBECCA PORTERFIELD MA, LPC-A

MEDICARE: REBECCA PORTERFIELD MA, LPC-A
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
1101Y00000XCounselor90793TX

General Provider Information

NPI Number : 1558067850
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA PORTERFIELD MA, LPC-A
Provider Business Mailing Address
First Line : 1501 AZALEA DR
Second Line :
City : LUFKIN
State : TX
Zip : 75904-5321
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 320 NORTH ST STE 206
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75961-5018
Country : US
Telephone Number : 936-244-5681
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2023
Last Update Date : 02/07/2023

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