WILLIAM DOUGLAS PORTIS


Address: 808 S Eldorado Rd Ste 100c, Bloomington, IL 61704-6075
Phone: 3098896222

WILLIAM DOUGLAS PORTIS (NPI# 1003316720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003316720
Entity Type Individual
Full Name WILLIAM DOUGLAS PORTIS
Credential LCPC CADC
Practice Address 808 S Eldorado Rd Ste 100c
Bloomington
IL 61704-6075
Mailing Address 1 Plantation Ct
Bloomington
IL 61704-9467
Practice Telephone 3098896222
Mailing Telephone 3098896222
Enumeration Date 2018-02-19
Last Update Date 2020-09-11
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
33398 IL Behavioral Health & Social Service Providers
Y 101YM0800X Counselor
Specialization: Mental Health
180012458 IL Behavioral Health & Social Service Providers
N 101YM0800X Counselor
Specialization: Mental Health
178.009416 IL Behavioral Health & Social Service Providers

Office Location

Street Address 808 S ELDORADO RD STE 100C
City BLOOMINGTON
State IL
Zip Code 61704-6075

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013526631 Sandra Clark Counselor 205 N College Avenue, Suite 210a, Bloomington, IN 47404 2020-07-29
1881218642 Amy Lynn Hootman Counselor 2806 W Fawkesway Dr, Bloomington, IN 47404-1211 2020-06-07
1568096543 Elm Services LLC Counselor 4076 N Brookwood Dr, Bloomington, IN 47404-9602 2020-02-27
1033759014 Joseph Gerbofsky Counselor 410 S Landmark Ave, Bloomington, IN 47403-5000 2020-01-08
1508416371 Amy Michelle Owens Counselor 400 W 7th St Ste 105g, Bloomington, IN 47404-3900 2019-09-13
1407401714 Nichole M Day Counselor 101 W Kirkwood Ave Ste 210, Bloomington, IN 47404-6133 2019-08-04
1548721574 Ashley Hilkey Counselor 4500 W Woodland Dr, Bloomington, IN 47404-9582 2019-03-31
1235695867 Sandra K. Tucker, Ms, Lmhc, LLC Counselor 822 W 1st St Ste 4, Bloomington, IN 47403-2382 2019-02-19
1487120903 Rebecca Anne Romberger Counselor 530 W Center, Bloomington, IL 61701-6170 2018-10-23
1740789635 Jonna Marie Capio Lmhc LLC Counselor 3925 E Hagan St Ste 307, Bloomington, IN 47401-8649 2018-02-06
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Competitor

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City BLOOMINGTON
Zip Code 61704

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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