Individual
MS. JEANNE HARBER PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
34004475A
IN
1041C0700X
Clinical Social Worker
Primary
34004475A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000174858
ANTHEM
—
01
—
0007385540
AETNA US HEALTHCARE
—
05
—
200522940A
—
IN
01
—
2204791
CIGNA
—
01
—
58639900
MAGELLAN BEHAVIORAL HEALT
—
Enumeration date
09/13/2005
Last updated
04/03/2024
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