Active NPI
Sandra Porter, LPC, NCC
- Mental Health Counselor
- Stockbridge, GA
National Provider Identifier
1497501928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC014491
- Practice address
- 245 Country Club Dr BLDG 100a
Stockbridge, GA 30281-7216 - Phone
- (404) 917-5725
- NPI assigned
- Apr 25, 2024
- Sex
- Female
- Sole proprietor
- No
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 | LPC014491 | GA | Primary |
Addresses
Primary practice location
245 Country Club Dr BLDG 100a
Stockbridge, GA 30281-7216
Mailing address
PO Box 390644
Snellville, GA 30039-0011
Phone (404) 917-5725
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 |
|---|---|---|---|
| LPC014491 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1497501928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 390644",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300390011",
"telephone_number": "404-917-5725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 COUNTRY CLUB DR BLDG 100A",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302817216",
"telephone_number": "404-917-5725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "SANDRA",
"credential": "LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC014491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.