Alice Faye Portis-Patterson, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

947-125 Issued in WI

Practice address

6939 Mariner Dr
Suite C
Racine, WI 53406-3938

Phone

(262) 886-8702

Fax

(262) 886-8713

NPI assigned

Jan 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Portis Marriage and Children Counseling Clinic, LLC

  • Professional Counselor
  • Racine, WI
  • NPI 1609046788
  Medicare reassignment NPD Authorized official
• Child, Marriage & Family Therapy Clinic

  • Professional Counselor
  • Racine, WI
  • NPI 1336264829
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568515922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 DAISY LN",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054606",
            "telephone_number": "262-554-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 MARINER DR",
            "address_2": "SUITE C",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063938",
            "telephone_number": "262-886-8702",
            "fax_number": "262-886-8713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTIS-PATTERSON",
        "first_name": "ALICE",
        "middle_name": "FAYE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "947-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "222157",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39228200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Polo, BS, CSAC, CSIT
• Nicholas Reinhart Pope, D.C.
• Porcaro Performance and Rehabilitation (Porcaro Physical Therapy)
• Ralph William Porcaro, DC
• Portis Marriage and Children Counseling Clinic, LLC
• Eric Post, A.T.C
• Jessica Poteat
• Tiffany L Powell, MT
• Premier Gentle Care Home Healthcare
• Sharon Lois Prevost

• Mental Health Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.