Active NPI
Courtney Porter
- Clinical Social Worker
- West Memphis, AR
National Provider Identifier
1558777896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7312-C
- Practice address
- 703 Calvin Avery Dr
West Memphis, AR 72301-6501 - Phone
- (870) 732-1878
- Fax
- (870) 702-7111
- NPI assigned
- Jul 8, 2014
- Last updated
- Mar 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7312-C | AR | Primary |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
703 Calvin Avery Dr
West Memphis, AR 72301-6501
Mailing address
703 Calvin Avery Dr
West Memphis, AR 72301-6501
Phone (870) 732-1878
Other practice location 1
2707 Browns Ln
Jonesboro, AR 72401-7213
Phone (870) 972-4939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Counseling Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Little Rock, AR
- NPI 1922534882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1558777896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 CALVIN AVERY DR",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "723016501",
"telephone_number": "870-732-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 CALVIN AVERY DR",
"city": "WEST MEMPHIS",
"state": "AR",
"postal_code": "723016501",
"telephone_number": "870-732-1878",
"fax_number": "870-702-7111"
}
],
"practiceLocations": [
{
"address_1": "2707 Browns Ln",
"address_purpose": "LOCATION",
"city": "Jonesboro",
"state": "AR",
"postal_code": "724017213",
"country_code": "US",
"telephone_number": "870-972-4939",
"fax_number": "870-972-4911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PORTER",
"first_name": "COURTNEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "7312-C",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Memphis, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.