Miriane Davila Portes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008351 Issued in NC

Practice address

875 Walnut St Ste 220
Cary, NC 27511-4215

Phone

(801) 633-1054

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1881635720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 WALNUT ST STE 220",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114215",
            "telephone_number": "801-633-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WALNUT ST STE 220",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114215",
            "telephone_number": "801-633-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTES",
        "first_name": "MIRIANE",
        "middle_name": "DAVILA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5348078-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhoomi Ponkiya
• Danielle Ponte, BCBA
• Elissa Herman Poor, A-GNP-C
• Elissa Pope, LPCA
• Pops ABA NC LLC
• Victoria Post
• Samantha Whitley Poteat, BS
• Teia M Poulin, LCMHCA
• Rachel Poulos, LCMHC
• Juan Justin Powe

• Clinical Social Worker in Cary, NC
• Providers in Cary, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.