RYAN T PORTER (NPI# 1487104667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487104667 |
| Entity Type | Organization |
| Organization Name | RYAN T PORTER |
| Other Organization Name | GUARDIAN LIGHTHOUSE, LTD |
| Practice Address |
150 E Cook Ave Suite 105 Libertyville IL 60048-2060 |
| Mailing Address |
513 Deer Crossing Ct Hainesville IL 60030-3855 |
| Practice Telephone | 8479713579 |
| Mailing Telephone | 8479713579 |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |
| Authorized Official Name | RYAN T PORTER (OWNERE) |
| Authorized Official Telephone | 8479713579 |
| Authorized Official Credential | LCPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180005697 | IL | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Guardian Lighthouse, LTD | Doing Business As Name - Organization |
| Street Address |
150 E COOK AVE SUITE 105 |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306923511 | Edward D. Zehr | Social Worker | 150 E Cook Ave, Libertyville, IL 60048-2060 | 2006-11-01 |
| 1114580446 | Darlene Mary Holop | Nutritionist | 150 E Cook Ave, Libertyville, IL 60048-2060 | 2019-04-22 |
| 1669939963 | Shannon Marie Cagle | Counselor | 150 E Cook Ave, Ste 100, Libertyville, IL 60048-2060 | 2019-02-23 |
| 1760857726 | Lauren Kay Hess-metz | Social Worker | 150 E Cook Ave, Libertyville, IL 60048-2060 | 2015-12-02 |
| 1881072924 | Bonnie Kaye Mitchell | Nurse Practitioner | 150 E Cook Ave, Suite 100, Libertyville, IL 60048-2060 | 2015-05-08 |
| 1093900771 | Vijayta G Bansal-kapuria | Psychiatry & Neurology | 150 E Cook Ave, Suite 100, Libertyville, IL 60048-2060 | 2007-09-06 |
| 1063562189 | Danielle L Gaffke | Social Worker | 150 E Cook Ave, Suite 105, Libertyville, IL 60048-2060 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316446438 | Ashlea Michele Palafox | Counselor | 1590 S Milwaukee Ave Ste 222, Libertyville, IL 60048-3785 | 2018-02-04 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1063937324 | Broadreach Counseling LLC | Counselor | 1580 S Milwaukee Ave Ste 104, Libertyville, IL 60048-3770 | 2017-08-08 |
| 1427422864 | Gina Tober | Counselor | 1113 S Milwaukee Ave Ste 104, Libertyville, IL 60048-3759 | 2015-11-23 |
| 1477974004 | Psych Sync Inc. | Counselor | 1203 Loyola Dr, Libertyville, IL 60048-1290 | 2013-12-28 |
| 1477801868 | Kathleen Murphy Papierniak | Counselor | 1117 South Milwaukee Ave, Suite-8, Libertyville, IL 60048-3798 | 2012-08-16 |
| 1609009604 | Ale Bugaro | Counselor | 1580 S Milwaukee Ave Ste 512, Libertyville, IL 60048-3776 | 2009-08-25 |
| 1306044706 | Deborah Renee Norton | Counselor | 128 Newberry Avenue, Suite #8, Libertyville, IL 60048-1923 | 2007-07-06 |
| 1538374889 | Janice A Prepura | Counselor | 501 W Peterson Rd, Allied Psychological Services Ltd, Libertyville, IL 60048 | 2007-05-11 |
| 1093853533 | Melissa Brennan | Counselor | 1248 American Way, Suite B, Libertyville, IL 60048-3936 | 2007-02-04 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on RYAN T PORTER.
| 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.