Provider Demographics
NPI:1790675957
Name:PORTEE, ERIC LARON (LPC-A, ADC-IP, NCC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LARON
Last Name:PORTEE
Suffix:
Gender:M
Credentials:LPC-A, ADC-IP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 ELECTRIC DRIVE SUMTER, SC 29153
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29153
Mailing Address - Country:US
Mailing Address - Phone:803-905-5100
Mailing Address - Fax:803-905-5171
Practice Address - Street 1:755 ELECTRIC DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29153-1933
Practice Address - Country:US
Practice Address - Phone:803-905-5100
Practice Address - Fax:803-905-5171
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10414101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional