Individual provider Active NPI

Jessica Marie Porter, LMHC

  • Mental Health Counselor
  • Lake Mary, FL
National Provider Identifier
1124786819
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH26488 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(321) 732-5617
NPI assigned
Nov 30, 2021
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH26488 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

1846 Shore Dr S Unit 102
South Pasadena, FL 33707-4659
Phone (126) 050-3913

Other practice location 1

1846 Shore Dr S Unit 102
South Pasadena, FL 33707-4659
Phone (126) 050-3913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260529000075 FL Practitioner - Mental Health Counselor 6800366006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH26488FLMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1124786819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1846 SHORE DR S UNIT 102",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074659",
            "telephone_number": "126-050-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "321-732-5617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1846 Shore Dr S Unit 102",
            "address_purpose": "LOCATION",
            "city": "South Pasadena",
            "state": "FL",
            "postal_code": "337074659",
            "country_code": "US",
            "telephone_number": "126-050-3913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH26488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.