Active NPI
Lisa Marie Porter
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1457718900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH17564
- Practice address
- 225 N Michigan Ave
Chicago, IL 60601 - Phone
- (407) 501-2994
- NPI assigned
- Jan 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH17564 | FL | Primary |
Addresses
Primary practice location
225 N Michigan Ave
Chicago, IL 60601
Mailing address
1121 Alice Dr Apt 68
Sumter, SC 29150-1604
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH17564 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life & Work Soulutions, Inc. | Past | Accepting new patients | |
| Mindpath Health Florida, PLLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Kissimmee, FL
- NPI 1023287901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1457718900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 ALICE DR APT 68",
"city": "SUMTER",
"state": "SC",
"postal_code": "291501604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 N MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60601",
"telephone_number": "407-501-2994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "LISA MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-27",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH17564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.