William Douglas Portis
Mental Health Counselor Addiction Counselor (Substance Use Disorder)
808 S Eldorado Rd Ste 100c
Bloomington
, Illinois 61704-6075
William Douglas Portis
Mental Health Counselor Addiction Counselor (Substance Use Disorder)
808 S Eldorado Rd Ste 100c
Bloomington
, Illinois 61704-6075
(309) 889-6222
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About
Features
Specialties
- Addiction Counselor (Substance Use Disorder)
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- William Douglas Portis
- 1 Plantation Ct
- Bloomington, IL
- Zip : 61704-9467
- Phone : (309) 889-6222
Second Address
- William Douglas Portis
- 808 S Eldorado Rd Ste 100c
- Bloomington, IL
- Zip : 61704-6075
- Phone : (309) 889-6222
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 33398 | IL |
| N | 101YM0800X | Mental Health Counselor | 178.009416 | IL |
| Y | 101YM0800X | Mental Health Counselor | 180012458 | IL |
National Provider Identifier
| NPI | 1003316720 |
|---|---|
| Provider Name | William Douglas Portis |
| First Address | Bloomington, IL 61704-9467 |
| Second Address | Bloomington, IL 61704-6075 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/02/2018 |
| Last Update Date | 11/09/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.