Dwight A Porter, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

006366 Issued in GA

Practice address

4405 Mall Blvd
Suite 200
Union City, GA 30291-2044

Phone

(770) 969-4309

Fax

(770) 969-4170

NPI assigned

Aug 13, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Chesterfield Family Guidance Center

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1225192909

  Professional

  Medicare reassignment NPD
• Pabs Unlimited, Inc

  • Exclusive Provider Organization
  • Union City, GA
  • NPI 1881035194
  NPD (past) Authorized official

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1194158220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "address_2": "SUITE 200",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "770-969-4309",
            "fax_number": "770-969-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 MALL BLVD",
            "address_2": "SUITE 200",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912044",
            "telephone_number": "770-969-4309",
            "fax_number": "770-969-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DWIGHT",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "006366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jarvis Alexander Perry, PHARMD
• Phyzer Homehealth Services, Inc
• Kiara Pierce
• Ruth Wilmine Pierre, PHARMD
• Melanie L. Ponder-Wright, LCSW
• Premed Medical Services, Inc.
• Premier Health Chiropractic Incorporated
• Prestigehealth Primary and Urgent Care LLC
• Priority Toxicology Laboratories
• Priority Toxicology Laboratories, LLC

• Professional Counselor in Union City, GA
• Providers in Union City, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.