Tiffany Renee Porter

Individual provider Active NPI Mental Health Counselor · Evergreen, AL

NPI 1629705751 · NPPES record last updated Aug 8, 2022

Key facts

NPI
1629705751
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
220 Magnolia Ave
Evergreen, AL 36401-3156
Phone
(251) 578-4545
Fax
(251) 575-9459
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Alabama Mental Health Past
since Aug 14, 2022
Accepting new patients
Southwest Alabama Behavioral Health Care Systems Past
since Aug 14, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

220 Magnolia Ave
Evergreen, AL 36401-3156

Mailing address

PO Box 964
Monroeville, AL 36461-0964
Phone (251) 575-4203

Other providers in Evergreen, AL

All providers in Evergreen, AL · Mental Health Counselor in Alabama

Sources for this page

Verify at the official NPI Registry.