Kendra Porter, MA | |
1200 S Pokegama Ave Ste 160, Grand Rapids, MN 55744-4296 | |
(218) 999-0051 | |
(218) 999-7020 |
Full Name | Kendra Porter |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 1200 S Pokegama Ave Ste 160, Grand Rapids, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598494635 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 02638 (Minnesota) | Primary |
Entity Name | Ellie Family Services Pllp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740664150 PECOS PAC ID: 8325309669 Enrollment ID: O20180228001972 |
Mailing Address | Practice Location Address |
---|---|
Kendra Porter, MA 1200 S Pokegama Ave Ste 160, Grand Rapids, MN 55744-4296 Ph: (218) 999-0051 | Kendra Porter, MA 1200 S Pokegama Ave Ste 160, Grand Rapids, MN 55744-4296 Ph: (218) 999-0051 |
Kayla Marie Meyer, MS, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 215 Se 2nd Ave, Grand Rapids, MN 55744 Phone: 218-326-1274 Fax: 218-326-9787 | |
Alyson Lopez, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 710 Allen Dr, Grand Rapids, MN 55744 Phone: 218-348-5643 | |
Colleen Mackay, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1215 Se 7th Ave, Grand Rapids, MN 55744 Phone: 218-313-1315 | |
Bruce Haag, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1215 Se 7th Ave, Grand Rapids, MN 55744 Phone: 218-327-1105 | |
Kelsey Unger, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 35382 Us Highway 2, Grand Rapids, MN 55744 Phone: 218-327-4886 Fax: 218-327-4848 | |
Christina Smith, CD Counselor Medicare: Not Enrolled in Medicare Practice Location: 2086 Ridgeway Dr, Grand Rapids, MN 55744 Phone: 218-327-9944 | |
Bret Decker, CAS, ADC-T Counselor Medicare: Not Enrolled in Medicare Practice Location: 516 S Pokegama Ave, Grand Rapids, MN 55744 Phone: 218-327-2001 Fax: 218-327-0456 |