Porter, Brandy K

Porter, Brandy K is an individual health care provider with primary practice located at 5905 Stewart Pkwy , Douglasville GA 30135-2371. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Porter, Brandy K can be contacted via phone (770) 949-8082.

Contact Information

Primary practice address
5905 Stewart Pkwy Douglasville GA 30135-2371
Phone: (770) 949-8082
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C0245 Georgia
Behavioral Health & Social Service Providers / Clinical 1041C0700X MSW008124 Georgia

Profile Details

NPI number 1982078382
LBN Legal business name Porter, Brandy K
Credentials LCSW, CAADC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2015
Last updated May 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982078382 NPPES
Georgia MEDICAID 1982078382

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