Courtney Porter Therapy, LLC
Organization Active NPI Clinical Social Worker · Savoy, IL
NPI 1194549352 · NPPES record last updated Nov 13, 2024
Key facts
- NPI
- 1194549352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- COURTNEY PORTER THERAPY, LLC
- Practice address
- 1801 Woodfield Dr # 212
Savoy, IL 61874-9505 - Phone
- (217) 898-9131
- NPI assigned
- Nov 13, 2024
- Organization subpart
- No
Authorized official
- Name
- Courtney Porter, LCSW
- Title
- Owner
- Phone
- (217) 898-9131
Practitioners 1
-
Courtney Ann Porter, LSW, MSW, M.ED.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250224000464 | IL | Part B Supplier - Clinic/Group Practice | 4385164219 |
Receives reassigned benefits from 1 practitioner Practice locations: Savoy, IL |
National Provider Directory
Locations
100 S King St
Newman, IL 61942
1801 Woodfield Dr
#212
Savoy, IL 61874
Phone (217) 898-9131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
1801 Woodfield Dr # 212
Savoy, IL 61874-9505
Mailing address
1801 Woodfield Dr # 212
Savoy, IL 61874-9505
Phone (217) 898-9131
Other providers in Savoy, IL
- Clark and Schulze NP Practice
- Brianna Coffey
- Cassandra Lee Colbert
- Cameron Rose Conroy
- Cooper Counseling PLLC
- Amber Courtright
- Carla J Cravens Mansini
- Marianne Croisant
- Cu Counseling PLLC
- Cup of Tea Counseling, LLC
All providers in Savoy, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.