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Individual

MS. REBECCA JANE PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LCMHC, LADC

Contact information

Practice address
1 S PROSPECT ST # 6207, BURLINGTON, VT 05401-3456
(802) 847-0000
Mailing address
1 S PROSPECT ST # 6207, BURLINGTON, VT 05401-3456
(802) 847-0000

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000508
VT
101YM0800X
Mental Health Counselor
Primary
068.0057799
VT

Other

Enumeration date
06/19/2012
Last updated
01/10/2024
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