Millicent Porter, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S4273 Issued in MS

Practice address

3054 Jackson Liberty Rd
Wesson, MS 39191-9688

Phone

(601) 757-0766

Fax

(601) 653-9590

NPI assigned

Apr 13, 2017

Last updated

Apr 13, 2017By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapy Nook PC

  • Speech-Language Pathologist
  • Brookhaven, MS
  • NPI 1619419694
  NPD (past) Authorized official

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1821522137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3054 JACKSON LIBERTY ROAD",
            "city": "WESSON",
            "state": "MS",
            "postal_code": "39191",
            "telephone_number": "601-757-0766",
            "fax_number": "601-653-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3054 JACKSON LIBERTY RD",
            "city": "WESSON",
            "state": "MS",
            "postal_code": "391919688",
            "telephone_number": "601-757-0766",
            "fax_number": "601-653-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MILLICENT",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Icare Services, LLC
• Lyndsay King, OTR/L
• Steven Barry Liverman, MD
• Gregory Matthew McClain, MS, ATC, LAT
• Susan Renee Moore, ATC, MS, LAT
• Rochland Shunta Porter
• Marcella Roberts, CNP
• Rebecca Lind Schrader, FNP
• Chastity Quayondra Sims, NP
• Angela N Smith, RN

• Speech-Language Pathologist in Wesson, MS
• Providers in Wesson, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.