KELLY PORTER (NPI# 1841774205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841774205 |
| Entity Type | Individual |
| Full Name | KELLY PORTER |
| Practice Address |
9605 Grand River Ave Detroit MI 48204-2139 |
| Practice Telephone | 3138345930 |
| Mailing Telephone | 3138345930 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639405806 | Kelly Marie Porter | Respite Care | 525 Harding Ave Nw, Massillon, OH 44646-3252 | 2009-10-23 |
| 1073086633 | Kelly Porter | Occupational Therapist | 625 Walnut St, Mckeesport, PA 15132-2806 | 2019-01-07 |
| 1932655008 | Kelly Porter | Technician, Other | 3231 S Gulley Rd, Dearborn, MI 48124-4407 | 2016-08-29 |
| 1972919413 | Kelly M Porter | Counselor | 444 Center St, Manchester, CT 06040-3926 | 2014-07-04 |
| 1700160843 | Kelly Maryann Porter | Dietitian, Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2011-10-07 |
| 1750611810 | Kelly M. Porter | Nurse Practitioner | 3333 Burnet Ave, Ml 2001, Cincinnati, OH 45229-3026 | 2010-01-12 |
| 1437331873 | Kelly Porter | Physician Assistant | 101 Orchard Dr, Trafford, PA 15085-1640 | 2007-11-28 |
| 1598946220 | Kelly E. Porter | Chiropractor | 12351 Capital Blvd, Wake Forest, NC 27587-7425 | 2007-11-22 |
| Street Address |
9605 GRAND RIVER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48204-2139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033251269 | Nardin Park Recovery Center,inc. | Clinic/Center | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2007-02-13 |
| 1053954354 | Geraldine Morehead-johnson | Registered Nurse | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2019-10-21 |
| 1467945279 | Audrey Hendricks | Counselor | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2018-06-07 |
| 1184143182 | Brittany Shanae Ford | Registered Nurse | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2017-09-12 |
| 1528506649 | Kelli Turner | Licensed Practical Nurse | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2017-02-09 |
| 1134662109 | Ilene Bishaw | Counselor | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2016-11-23 |
| 1871974568 | Tamiko Conner | Counselor | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2015-06-18 |
| 1821485087 | Heather Rajter | Registered Nurse | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2015-04-24 |
| 1902200454 | David Scott | Counselor | 9605 Grand River Ave, Detroit, MI 48204-2139 | 2014-10-13 |
| 1164839262 | Audrey Douglas | Counselor | 9605 Grand River Ave, Detroit, MI 48204-3129 | 2014-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033763347 | Latrese Tucker | Contractor | 9600 Wyoming, Detroit, MI 48204 | 2019-07-25 |
| 1023477296 | Lloyd Tender Care LLC | Home Health | 8360 Alpine, Detroit, MI 48204 | 2016-02-17 |
| 1104132703 | Chelseas Home Care | Custodial Care Facility | 12391 Birwood, Detroit, MI 48204 | 2010-08-20 |
| 1407001332 | Wards Holy Management Outreach Church | Point of Service | 12410 Wyoming St Fl 2, Detroit, MI 48204 | 2008-11-19 |
| 1346498250 | Jamila B Boulaalam | Dentist | 9685 Gd River, Detroit, MI 48204 | 2008-09-04 |
| 1245427186 | Hollis Whitcliffe James | Dentist | 10241 Joy Road, Detroit, MI 48204 | 2007-09-25 |
| 1861510679 | Roger James Gregory | Counselor | 9605 West Grand River, Nardin Park Recovery Center, Detroit, MI 48204 | 2007-03-27 |
| 1558464743 | Gerald Jacob Najor | Pharmacist | 7350 Grand River, Fraser Drugs, Detroit, MI 48204 | 2006-09-06 |
| 1255449740 | Deborah Oliver | Dentist | 8325 Grand River, Detroit, MI 48204 | 2006-08-26 |
| 1427148618 | Rite- Way Hardware Inc | Pharmacy | 7350 Grand River, Detroit, MI 48204 | 2006-10-16 |
| Find all providers in zip 48204 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251841 | Diversified Community Services | Counselor | 10301 W 7 Mile Rd, Detroit, MI 48221-1962 | 2020-09-29 |
| 1750907853 | Ronnie Stephen | Counselor | 15025 Fenkell St, Detroit, MI 48227-2647 | 2020-06-24 |
| 1144860552 | Allen Hugh Warrick IIi | Counselor | 9605 Grand River Ave # A, Detroit, MI 48204-2139 | 2020-01-14 |
| 1396309878 | Darnesha Coy | Counselor | 17870 Dresden St, Detroit, MI 48205-3138 | 2019-04-30 |
| 1518438746 | Curron Thomas | Counselor | 16850 Wyoming St, Apartment 328, Detroit, MI 48221-3415 | 2018-12-16 |
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1205304359 | Life Challenge of Southeastern Michigan | Counselor | 17667 Pierson St, Detroit, MI 48219-2520 | 2018-11-07 |
| 1598233892 | Michigan Employment & Training Plus | Counselor | 6522 Piedmont St, Detroit, MI 48228-4950 | 2018-11-05 |
| 1821588773 | Avery Brown Jr. | Counselor | 8333 Townsend St, Detroit, MI 48213-2331 | 2018-05-16 |
| 1538669304 | Helping Hands Community Centers 1 | Counselor | 2434 Chicago Blvd, Detroit, MI 48206-1741 | 2018-02-17 |
| Find all providers in DETROIT | ||||
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| 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.