Porche Wynn, PHD, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4115 Issued in TN

Practice address

318 N Gay St Ste 210
Knoxville, TN 37917-7515

Phone

(865) 370-7705

NPI assigned

Jul 16, 2009

Last updated

Jun 21, 2024By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Marriage and Family Therapist

Education

University of Tennessee, HSC, College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Knoxville Leadership Foundation

  • Marriage & Family Therapist
  • Knoxville, TN
  • NPI 1952176919

  Mental Health

  Medicare reassignment NPD
• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD (past)

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1225268881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N GAY ST STE 210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177515",
            "telephone_number": "865-370-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N GAY ST STE 210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177515",
            "telephone_number": "865-370-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "PORCHE",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4115",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032977",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robbi A Wyatt, NP
• Scotty Wyatt, PHARMD
• Sharon Renee Wyatt
• Steven Charles Wyatt, PH.D.
• Addison Wyckoff, PA-C
• Jay Scott Wyrick, PHARMD
• Madelyn Wyrick
• Nicholas Peter Xenopoulos, MD
• Amber Michelle Xenos, BS
• Beth Black Xue, PHARM.D.

• Professional Counselor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.