Individual provider Active NPI

Austin M Portch, MA

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1144798026
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61020431 Issued in WA
Practice address
2118 E Sprague Ave
Spokane, WA 99202-3125
Phone
(509) 838-4651
NPI assigned
Nov 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60859064 WA
Mental Health Counselor 101YM0800X LH61020431 WA Primary

Addresses

Primary practice location

2118 E Sprague Ave
Spokane, WA 99202-3125

Mailing address

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

Other identifiers 1

IdentifierTypeStateIssuer
2114397MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CG60859064WAMDCounselor
LH61020431WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Behavioral Health Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2102 E Sprague Ave
Spokane, WA 99202

107 S Division St
Spokane, WA 99202
Phone (509) 383-4651

2118 E Sprague Ave
Spokane, WA 99202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1144798026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 E SPRAGUE AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023125",
            "telephone_number": "509-838-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTCH",
        "first_name": "AUSTIN",
        "middle_name": "M",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-08",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60859064",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61020431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2114397",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.