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).
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 |
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 |
Street Address |
808 S ELDORADO RD STE 100C |
City | BLOOMINGTON |
State | IL |
Zip Code | 61704-6075 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
Find all providers in zip 61704 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
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 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 61704 |
Please comment or provide details below to improve the information on WILLIAM DOUGLAS PORTIS.
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.