Porsha Gonder-McDonald, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2201003 Issued in AR

Practice address

620 S Laurel St
Pine Bluff, AR 71601-4859

Phone

(870) 534-4900

Fax

(870) 534-4906

NPI assigned

Feb 12, 2018

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Broken Crayons, LLC

  • Professional Counselor
  • Pine Bluff, AR
  • NPI 1437883774
  NPD
• BHC Pinnacle Pointe Hospital LLC

  dba Pinnacle Pointe Hospital

  • Psychiatric Hospital
  • Little Rock, AR
  • NPI 1912962341
  NPD (past)
• BHC Pinnacle Pointe Hospital, Inc.

  dba The Pointe Outpatient Behavioral Health Services

  • Adolescent and Children Mental Health Clinic/Center
  • White Hall, AR
  • NPI 1649542366
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1851890248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S MISSOURI ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014470",
            "telephone_number": "870-395-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S LAUREL ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014859",
            "telephone_number": "870-534-4900",
            "fax_number": "870-534-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDER-MCDONALD",
        "first_name": "PORSHA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A2001008",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2201003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180635526",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "porch.mcdonald@thepatcenter.org",
            "affiliation": "N",
            "address_1": "620 S Laurel St",
            "city": "Pine Bluff",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716014859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelia Monette Glass
• Hailee Lynne Glasscock
• Tamara Glover, LCSW
• Debra C Goldmon, MS RD LD
• Kwaeisi Golliday
• Crystal Gonder, A2508010
• Commeka Goodloe
• Rhamonia Lynetta Goodlow, LPN
• Tacarra Michelle Goodwin, LCSW
• Destiny Gordon

• Professional Counselor in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.