Dan Kenneth Porter, LISW, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I3749 Issued in OH

Practice address

8445 Munson Rd
Mentor, OH 44060-2410

Phone

(440) 255-1700

Fax

(440) 205-2417

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750420113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 OLD STATE RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249255",
            "telephone_number": "440-286-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8445 MUNSON RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440602410",
            "telephone_number": "440-255-1700",
            "fax_number": "440-205-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DAN",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I3749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Polakowski, PT
• Margaret Polk
• Ryan C Polman, DDS
• Daniella Anne Ponomarenko
• Alison Pophal, PT, DPT
• Marie Denise Porter, CDCA
• Natiata Sarudzai Porter
• Ronald Edgar Posner, MD
• Sue Potokar, RN
• Rebekah Powell, CPRS

• Clinical Social Worker in Mentor, OH
• Providers in Mentor, OH by specialty
• Clinical Social Worker in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.