Individual
TIMOTHY PAUL PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
340 W B ST STE 204, CASPER, WY 82601-1839
(307) 439-6424
Mailing address
PO BOX 50373, CASPER, WY 82605-0373
(307) 439-6424
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
BBH-SWLC-LIC-50447
MT
1041C0700X
Clinical Social Worker
Primary
LCSW-1465
WY
1041C0700X
Clinical Social Worker
MBTSWO-44324
ID
1041C0700X
Clinical Social Worker
SC61282484
WA
Other
Enumeration date
12/08/2017
Last updated
11/25/2025
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