Individual provider Active NPI

Tammy Porter, PSC, LAPC, NCC

  • Mental Health Counselor
  • Metter, GA
National Provider Identifier
1336763192
Registry record updated Jun 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAPC Issued in GA
Practice address
5 SW Broad St
Metter, GA 30439-4433
Phone
(912) 515-5026
NPI assigned
Jun 7, 2020
Last updated
Jun 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X X GA
Mental Health Counselor 101YM0800X LAPC GA Primary
School Counselor 101YS0200X X GA

Addresses

Primary practice location

5 SW Broad St
Metter, GA 30439-4433

Mailing address

5 SW Broad St
Metter, GA 30439-4433
Phone (912) 515-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240708002133 GA Practitioner - Mental Health Counselor 2567907157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAPCGAMDMental Health Counselor
XGAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Counseling Solutions, LLC Addiction (Substance Use Disorder) CurrentSince Mar 19, 2023 Accepting new patients
Creative Counseling Solutions, LLC Addiction (Substance Use Disorder) PastSince Jun 14, 2020 Accepting new patients

Locations

5 SW Broad St
Metter, GA 30439
Phone (912) 507-4883

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1591488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591488000000",
    "number": "1336763192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SW BROAD ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394433",
            "telephone_number": "912-515-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SW BROAD ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394433",
            "telephone_number": "912-515-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "TAMMY",
        "credential": "PSC, LAPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-07",
        "last_updated": "2020-06-07",
        "certification_date": "2020-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "X",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LAPC",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "GA",
            "license": "X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metter, GA

Sources for this page

Verify at the official NPI Registry.