Individual provider Active NPI

Edward Porter

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1275219446
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5707 N 22ND St
Tampa, FL 33610-4350
Phone
(813) 239-8069
NPI assigned
Jun 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5707 N 22ND St
Tampa, FL 33610-4350

Mailing address

5707 N 22ND St
Tampa, FL 33610-4350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20260113002284 FL Practitioner - Clinical Social Worker 2769968387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12606 Montford LN
Riverview, FL 33579-7754

9835 Lake Worth Rd
Lake Worth, FL 33467-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW25717FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. CurrentSince Nov 16, 2025 Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

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": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1275219446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-239-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.