Provider Demographics
NPI:1417657255
Name:POTEAT, CAROLIE DIONNE
Entity Type:Individual
Prefix:
First Name:CAROLIE
Middle Name:DIONNE
Last Name:POTEAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 ACCOKEEK LANDING DR
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-2271
Mailing Address - Country:US
Mailing Address - Phone:301-792-8885
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1848
Practice Address - Country:US
Practice Address - Phone:202-269-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician