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Individual

MR. DARREN MICHAEL PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSAC

Contact information

Practice address
2979 ALLIED ST, GREEN BAY, WI 54304-5567
(920) 337-6740
(920) 337-6741
Mailing address
2422 N GRANDVIEW BLVD, WAUKESHA, WI 53188-6105
(262) 549-6600
(920) 445-0174

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15865-132
WI
101YP2500X
Professional Counselor
Primary
10020-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15865-132
CLINICAL SUBSTANCE ABUSE COUNSELOR
WI
Enumeration date
03/09/2010
Last updated
12/09/2024
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