MRS. WILLOW GREEN PORTELA (NPI# 1194360925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194360925 |
| Entity Type | Individual |
| Full Name | MRS. WILLOW GREEN PORTELA |
| Credential | LPC-A |
| Practice Address |
101 Colvard St Jefferson NC 28640-9797 |
| Mailing Address |
284 Executive Park Dr Ste 100 Concord NC 28025-1833 |
| Practice Telephone | 3362464542 |
| Practice Fax Number | 3362462364 |
| Mailing Telephone | 7049391100 |
| Mailing Fax Number | 7049391173 |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2019-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
A15333 | NC | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1650 Nc Highway 18 S, Sparta, NC 286758478 | 3363724095 | 3363722722 |
| Street Address |
101 COLVARD ST |
| City | JEFFERSON |
| State | NC |
| Zip Code | 28640-9797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275500761 | Paige A Stephens | Counselor | 101 Colvard St, Jefferson, NC 28640-9797 | 2006-03-02 |
| 1477034791 | Robin Jones | Clinical Nurse Specialist | 101 Colvard St, Jefferson, NC 28640 | 2018-08-24 |
| 1700329042 | Richard Allen Bare | Counselor | 101 Colvard St, Jefferson, NC 28640-9797 | 2016-11-18 |
| 1851847511 | Courtney Camp Benson | Counselor | 101 Colvard St, Jefferson, NC 28640 | 2016-08-31 |
| 1700156551 | Jennifer Archer Keely | Counselor | 101 Colvard St, Jefferson, NC 28640-9797 | 2012-01-11 |
| 1699042986 | Daymark Recovery Service Inc | Counselor | 101 Colvard St, Unit 1, Jefferson, NC 28640-9797 | 2011-11-30 |
| 1720364250 | Daymark Recovery Services Inc | Counselor | 101 Colvard St, Unit 1, Jefferson, NC 28640-9797 | 2011-10-28 |
| 1669638599 | Ashley Wayne Harris | Counselor | 101 Colvard St, Jefferson, NC 28640-9797 | 2008-07-30 |
| 1194917823 | Jonna M. Mcgarity | Social Worker | 101 Colvard St, Unit 2, Jefferson, NC 28640-9797 | 2007-08-16 |
| 1659414449 | Marian J. Peters | Physician Assistant | 101 Colvard St, Jefferson, NC 28640-9797 | 2007-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917710 | Lux Psychiatry, Pllc | Psychiatry & Neurology | 101 Colvard Street, Jefferson, NC 28640 | 2020-06-17 |
| 1902466543 | Emily Claire Wilson | Physical Therapist | 419 East Main Street Unit 4, Jefferson, NC 28640 | 2019-06-17 |
| 1457824393 | Miranda Lyalls Jordan | Nurse Practitioner | 310 Hospital Ave, Jefferson, NC 28640 | 2019-01-03 |
| 1659859247 | Molly Reynolds | Physical Therapist | 419 E. Main St. Unit 4, Jefferson, NC 28640 | 2018-08-06 |
| 1548644040 | Amanda Stroud | Dentist | 225 Court Street, Jefferson, NC 28640 | 2015-07-14 |
| 1710388772 | Schuster Physical Therapy Inc. | Clinic/Center | 419 E. Main St., Jefferson, NC 28640 | 2014-09-09 |
| 1437589199 | Rebecca Scoggin Clark | Nurse Practitioner | 413 Mcconnell Street, Jefferson, NC 28640 | 2013-11-16 |
| 1093029498 | Robin Arlene Edwards | Nurse Practitioner | 151 Medical Park Dr., Jefferson, NC 28640 | 2010-07-28 |
| 1659516979 | Patricia Ann Franklin | Physical Therapist | 125 Colvard Farm Rd, Unit 7, Jefferson, NC 28640 | 2008-12-16 |
| 1730363342 | Ashe County Public Schools | Local Education Agency (LEA) | 320 South Street, Jefferson, NC 28640 | 2007-12-19 |
| Find all providers in zip 28640 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522863 | Brandon Shurn | Counselor | 4014 Mountville Rd # J, Jefferson, MD 21755-7713 | 2018-09-20 |
| 1821598491 | Kathryn Marie Stingl | Counselor | 115 S Fischer Ave, Jefferson, WI 53549-2123 | 2018-02-20 |
| 1306113279 | Navjot A. Redpath | Counselor | 1500 River Oaks Road W., Suite 100-a, Jefferson, LA 70123 | 2011-11-21 |
| 1326322934 | Ashleigh Gros Castro | Counselor | 2606 Audubon Trce, Jefferson, LA 70121-1561 | 2011-09-30 |
| 1346564416 | Allen Sinclair Young | Counselor | 827 Jefferson Walk Cir, Jefferson, GA 30549-5582 | 2010-03-18 |
| 1649425224 | Diane Wait | Counselor | 514 Mcconnell St, Jefferson, NC 28640-9789 | 2008-11-24 |
| 1225163603 | Jenny Diane Gibbs | Counselor | 224 North Main Street, Jefferson, NC 28640 | 2007-02-23 |
| 1477613180 | Todd S Capielano | Counselor | 4728 Jefferson Hwy, Jefferson, LA 70121-3125 | 2006-12-11 |
| 1184679680 | Martin Lyle Plog | Counselor | 2610 Highway 129 N, Jefferson, GA 30549-2652 | 2006-05-23 |
| 1922064864 | David John Ohrt | Counselor | 1217 W Lincolnway St, Jefferson, IA 50129-1671 | 2006-04-20 |
| Find all providers in JEFFERSON | ||||
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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.