Elizabeth Porter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007078A Issued in IN

Practice address

4109 W Jefferson Blvd
Ste a
Fort Wayne, IN 46804-8694

Phone

(260) 486-5251

Fax

(260) 486-5058

NPI assigned

Jan 31, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

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.

• Consulting & Counseling Associates, LLC

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1962432971

  Mental Health

  NPD

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1619216389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 W JEFFERSON BLVD",
            "address_2": "STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468048694",
            "telephone_number": "260-486-5251",
            "fax_number": "260-486-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 W JEFFERSON BLVD",
            "address_2": "STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468048694",
            "telephone_number": "260-486-5251",
            "fax_number": "260-486-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007078A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "33006395A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Rae Poore
• Megan Briana Popp, LSW, MSW
• Alece Porter, BA
• Alexa Porter
• Alston Michael Porter, M.D.
• Kian Porter, M.D.
• Paul William Porter, MD
• Scott B Porter, M.D.
• Positive Change LLC
• Positive Expressions Inc

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.