Provider Demographics
NPI:1285289983
Name:PORTERFIELD, KAREN LEE (MA)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LEE
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 CALVERT CT
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6153
Mailing Address - Country:US
Mailing Address - Phone:949-295-9301
Mailing Address - Fax:
Practice Address - Street 1:137 CALVERT CT
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-6153
Practice Address - Country:US
Practice Address - Phone:949-295-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional