Individual
MRS. GWENDOLYN MARIA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, LCSW
Contact information
Practice address
923 SENIOR CIRCLE, MACY, NE 68039-4018
(402) 837-5381
(402) 837-5303
Mailing address
PO BOX 250, MACY, NE 68039-0250
(402) 837-5381
(402) 837-5303
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2520
NE
1041C0700X
Clinical Social Worker
Primary
4112
NE
1041C0700X
Clinical Social Worker
6316
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10029327901
—
NE
Enumeration date
08/31/2016
Last updated
05/16/2025
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