Provider Demographics
NPI:1306135165
Name:PORTER, DELICIA LASHELE (LPC)
Entity type:Individual
Prefix:MS
First Name:DELICIA
Middle Name:LASHELE
Last Name:PORTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8724 E PARKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73141-2240
Mailing Address - Country:US
Mailing Address - Phone:405-769-7738
Mailing Address - Fax:405-769-7738
Practice Address - Street 1:8724 E PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73141-2240
Practice Address - Country:US
Practice Address - Phone:405-769-7738
Practice Address - Fax:405-769-7738
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 171M00000X
OK10361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1821508763OtherMETRO FAMILY THERAPY
OK1154518330OtherNEW HORIZON YOUTH & FAMILY SERVICES
OK1255854725OtherCTC MISSION TREATMENT