MEDICARE: DR. CHRISTOPHER A PORCH

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
1	101YM0800X	Mental Health Counselor	LMHC10000193	MA
2	101YP2500X	Professional Counselor	LPC012496	GA

General Provider Information

NPI Number	:	1861122400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER A PORCH

Provider Business Mailing Address
First Line	:	58 MEADOW VALLEY CT
Second Line	:
City	:	MIDLAND
State	:	GA
Zip	:	31820-4393
Country	:	US
Telephone Number	:	706-593-9687
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 MEADOW VALLEY CT
Second Line	:
City	:	MIDLAND
State	:	GA
Zip	:	31820-4393
Country	:	US
Telephone Number	:	706-593-9687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2022
Last Update Date	:	05/01/2025

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Directions to “ DR. CHRISTOPHER A PORCH ” Practice Location

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