Provider Demographics
NPI:1861633869
Name:POTTER, EMILY J (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:POTTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11695 S BLACKBOB RD STE B
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1021
Mailing Address - Country:US
Mailing Address - Phone:913-768-6606
Mailing Address - Fax:913-768-6609
Practice Address - Street 1:11695 S BLACKBOB RD STE B
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1021
Practice Address - Country:US
Practice Address - Phone:913-768-6606
Practice Address - Fax:913-768-6609
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1043106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist