Provider Demographics
NPI:1730285669
Name:POTTER, JAMES H (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:POTTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8424 FM 350 N
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-6503
Mailing Address - Country:US
Mailing Address - Phone:936-646-3056
Mailing Address - Fax:903-727-0210
Practice Address - Street 1:8424 FM 350 N
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-6503
Practice Address - Country:US
Practice Address - Phone:936-646-3056
Practice Address - Fax:903-727-0210
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14347101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor