Ryan T Porter

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180005697 Issued in IL

Legal business name

RYAN T PORTER

Doing business as

Guardian Lighthouse, LTD

Practice address

150 E Cook Ave
Suite 105
Libertyville, IL 60048-2060

Phone

(847) 971-3579

NPI assigned

Oct 11, 2016

Organization subpart

No

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

Authorized official

Name

Ryan T Porter, LCPCNPI 1811184955

Title

Ownere

Phone

(847) 971-3579

Specialties & licenses 1

Addresses

Other names 1

• Guardian Lighthouse, LTD Doing business as

Tax ID family

Guardian Lighthouse2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Guardian Lighthouse

  dba Guardian Youth and Family Counseling

  • Mental Health Counselor
  • Glen Ellyn, IL
  • NPI 1164793840
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Troy Porter

  • Professional Counselor
  • Mesa, AZ
  • NPI 1811184955
  NPD (past) Authorized official

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1487104667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 DEER CROSSING CT",
            "city": "HAINESVILLE",
            "state": "IL",
            "postal_code": "600303855",
            "telephone_number": "847-971-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E COOK AVE",
            "address_2": "SUITE 105",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482060",
            "telephone_number": "847-971-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN T PORTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNERE",
        "authorized_official_telephone_number": "847-971-3579",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guardian Lighthouse, LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather A Rueben, FNP-C
• James E Ruffer, M.D.
• Rush-Select Holdings, LLC. (Rush Kids Pediatric Therapy)
• Rush-Select Holdings, LLC. (RUSH Physical Therapy)
• Meggan L Rutledge, D.D.S.
• Victoria Anna Rzucidlo, PA-C
• Hannah Sabres, MS, OTRL
• Nasiredin Sadeghi
• Elizabeth Mary Saip, DPT
• Joseph Salata, DMD

• Professional Counselor in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.