Search › Georgia › 1041C0700X
Clyte Portis, LCSW, LISW-CP
NPI 1447423157 · on the registry since 2008
Practice
- Address
- 254 41st St
Bldg 40709
Fort Gordon, GA 30905 - Phone
- (707) 787-1595
- Fax
- (706) 787-1099
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 104100000X
1041S0200X - Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-10-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia