Female

Ms. Theresa A. Porter LICSW

Social Worker in Bismarck, ND(View on Map)

Full Name

Ms. Theresa Ann Porter LICSW

NPI Number

1386755023

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/31/2006

Specialties

(Taxonomies)

Code

104100000X
1041C0700X

Primary Taxonomy

Yes
No

Licenses

State

North Dakota

License Number

2020

Contact
Information

Purpose

Mailing
Location

Address

600 SOUTH 2ND STREET
600 SOUTH 2ND STREET

City

Bismarck
Bismarck

State

ND
ND

Postal Code

58504-5729
58504-5729

Country

US
US

Telephone Number

(701) 258-3780
(701) 258-3780

Identifiers

Identifier

26413
BCBS 26413
PIN 19146
19146
HP65337

Identifier State

ND
ND
ND
ND
Unknown

Identifier Issuer

BCBS
MSW,LICSW
Unknown
Unknown
HEALTH PARTNERS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/03/2010

Provider Address

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