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Individual
VAN LAWRENCE PORTER
Active
Individual
VAN LAWRENCE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CDCA,QMHS, CMS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.172699
OH
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/15/2019
Last updated
01/31/2020
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