Provider Demographics
NPI:1295696615
Name:PORTER WELLNESS INC
Entity type:Organization
Organization Name:PORTER WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOGAN
Authorized Official - Middle Name:LUNNING
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-661-3391
Mailing Address - Street 1:1734 63RD ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-5950
Mailing Address - Country:US
Mailing Address - Phone:515-318-7062
Mailing Address - Fax:515-318-7062
Practice Address - Street 1:3209 INGERSOLL AVE STE 100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3920
Practice Address - Country:US
Practice Address - Phone:515-318-7062
Practice Address - Fax:515-318-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty