Provider Demographics
NPI:1093432585
Name:PORTERFIELD, RUSKEE (LCSW)
Entity type:Individual
Prefix:
First Name:RUSKEE
Middle Name:
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RUSKEE
Other - Middle Name:
Other - Last Name:PORTERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3810 WOODLANDS DR SE APT 3810
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8415
Mailing Address - Country:US
Mailing Address - Phone:678-425-5810
Mailing Address - Fax:
Practice Address - Street 1:3810 WOODLANDS DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8415
Practice Address - Country:US
Practice Address - Phone:678-425-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009647104100000X
GACSW009291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty