Active NPI
Portia Rene Archer, LCSW
- Social Worker
- Fulton, NY
National Provider Identifier
1013298090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- P81657
- Practice address
- 98 N 2ND St
Suite 100
Fulton, NY 13069-1254 - Phone
- (315) 326-3555
- Fax
- (315) 326-3565
- NPI assigned
- Sep 2, 2011
- Last updated
- Jan 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | P81657 | NY | Primary |
Addresses
Primary practice location
98 N 2ND St
Suite 100
Fulton, NY 13069-1254
Mailing address
98 N 2ND St
Suite 100
Fulton, NY 13069-1254
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P81657 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1013298090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 N 2ND ST",
"address_2": "SUITE 100",
"city": "FULTON",
"state": "NY",
"postal_code": "130691254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 N 2ND ST",
"address_2": "SUITE 100",
"city": "FULTON",
"state": "NY",
"postal_code": "130691254",
"telephone_number": "315-326-3555",
"fax_number": "315-326-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "PORTIA",
"middle_name": "RENE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-02",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "P81657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.