Jennifer T Porter, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C4775 Issued in MS

Practice address

109 Deerfield Rd
Guntown, MS 38849-7975

Phone

(662) 891-7567

NPI assigned

Aug 5, 2022

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uppal Medical Center LLCGroup PAC ID 4587998547, 129 clinicians

MDB Behavioral Health Services LLCGroup PAC ID 0749572915, 201 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment Care Compare group NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Medicare reassignment Care Compare group NPD
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment
• Minor Med Care, LLC

  • Rural Health Clinic/Center
  • Raymond, MS
  • NPI 1669575627
  NPD

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1144957408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 DEERFIELD RD",
            "city": "GUNTOWN",
            "state": "MS",
            "postal_code": "388497975",
            "telephone_number": "662-401-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 DEERFIELD RD",
            "city": "GUNTOWN",
            "state": "MS",
            "postal_code": "388497975",
            "telephone_number": "662-891-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JENNIFER",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "C4775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "6628917567",
            "affiliation": "N",
            "endpointDescription": "6628917567",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 Deerfield Rd",
            "city": "Guntown",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388497975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sabrina Latesha Hill Wright
• Rebecca Hill
• Fulumirani McCoy, NP
• Kevin Oneal Miller, NP
• Mary Katherine Oglesby, MCD, CCC-SLP
• Brenda Sensing
• Loretta Jean Smith, FNP
• Ashlyn Elena Stevens, FNP
• Austin Tyler Walker, RN

• Mental Health Counselor in Guntown, MS
• Providers in Guntown, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.