Provider Demographics
NPI:1356087530
Name:SUPERIOR POTENTIAL P.L.L.C.
Entity Type:Organization
Organization Name:SUPERIOR POTENTIAL P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GENEROU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:906-322-9576
Mailing Address - Street 1:7602 STATE HIGHWAY M123
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-8128
Mailing Address - Country:US
Mailing Address - Phone:906-322-9576
Mailing Address - Fax:906-293-7150
Practice Address - Street 1:7602 STATE HIGHWAY M123
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-8128
Practice Address - Country:US
Practice Address - Phone:906-322-9576
Practice Address - Fax:906-293-7150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty