Individual
JENNIFER LYNN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-1267
(844) 807-3782
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 783-1267
(844) 807-3782
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-43510
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962889477
—
ID
05
—
2113084
—
WA
Enumeration date
05/04/2015
Last updated
05/11/2026
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