Provider Demographics
NPI:1497522049
Name:POTTER, DEBORAH ANN (LLMSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:POTTER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MINGES CREEK PL APT D307
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-5788
Mailing Address - Country:US
Mailing Address - Phone:269-719-6177
Mailing Address - Fax:
Practice Address - Street 1:2017 4TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-4572
Practice Address - Country:US
Practice Address - Phone:517-581-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical