Provider Demographics
NPI:1871489906
Name:PORTER, LE ANN (LLPC)
Entity type:Individual
Prefix:
First Name:LE ANN
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SAND CREEK HWY APT K
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9182
Mailing Address - Country:US
Mailing Address - Phone:517-918-6931
Mailing Address - Fax:
Practice Address - Street 1:308 S MAUMEE ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2033
Practice Address - Country:US
Practice Address - Phone:517-423-6889
Practice Address - Fax:517-423-6890
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health