Mr Darren Michael Porter, CSAC | |
2979 Allied St, Green Bay, WI 54304-5567 | |
(920) 337-6740 | |
(920) 337-6741 |
Full Name | Mr Darren Michael Porter |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 2979 Allied St, Green Bay, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336462068 | NPI | - | NPPES |
15865-132 | Other | WI | CLINICAL SUBSTANCE ABUSE COUNSELOR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15865-132 (Wisconsin) | Secondary |
101YP2500X | Counselor - Professional | 10020-125 (Wisconsin) | Primary |
Entity Name | Thrive Therapy Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922557800 PECOS PAC ID: 2062749815 Enrollment ID: O20190816000698 |
Mailing Address | Practice Location Address |
---|---|
Mr Darren Michael Porter, CSAC 2422 N Grandview Blvd, Waukesha, WI 53188-6105 Ph: (262) 549-6600 | Mr Darren Michael Porter, CSAC 2979 Allied St, Green Bay, WI 54304-5567 Ph: (920) 337-6740 |
Louise Clara Daul, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 123 N Oakland Ave, Green Bay, WI 54303 Phone: 920-770-4088 Fax: 651-705-0026 | |
Kristin Flannery, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2920 S Webster Ave, Green Bay, WI 54301 Phone: 920-639-1914 | |
Robyn L Rickert, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 E Walnut St, Suite 406, Green Bay, WI 54301 Phone: 920-884-1187 Fax: 920-227-4100 | |
Joanne Marie Torres, LPC, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2640 West Point Road, Green Bay, WI 54304 Phone: 920-490-3790 | |
Mr. Christopher Anthony Buckman, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1499 6th St, Green Bay, WI 54304 Phone: 920-497-6161 Fax: 920-498-0476 | |
Jodi Anderson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2325 Verlin Rd Ste 203, Green Bay, WI 54311 Phone: 920-655-0859 | |
Stephanie Larson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1499 Sixth Street, Green Bay, WI 54304 Phone: 920-497-6161 Fax: 920-498-0476 |