Individual provider Active NPI

Philip W Porter

  • Mental Health Counselor
  • Spartanburg, SC
National Provider Identifier
1396930194
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6536 Issued in SC
Practice address
460 Langdon St.
Spartanburg, SC 29302-1614
Phone
(864) 582-2411
Fax
(864) 594-0040
NPI assigned
Sep 14, 2007
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 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 6536 SC Primary

Addresses

Primary practice location

460 Langdon St.
Spartanburg, SC 29302-1614

Mailing address

P.O. Box 5158
Spartanburg, SC 29304
Phone (864) 582-2411

Other practice location 1

250 Dewey Ave
Spartanburg, SC 29303-3009
Phone (864) 585-0366 ext. 127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6536SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1396930194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5158",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "29304",
            "telephone_number": "864-582-2411",
            "fax_number": "864-594-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 LANGDON ST.",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021614",
            "telephone_number": "864-582-2411",
            "fax_number": "864-594-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Dewey Ave",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033009",
            "country_code": "US",
            "telephone_number": "864-585-0366 x127",
            "fax_number": "864-585-9208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PHILIP",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.