Provider Demographics
NPI:1982200432
Name:POTTER, ALISON LYNDSEY (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LYNDSEY
Last Name:POTTER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 9TH PL SE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-3446
Mailing Address - Country:US
Mailing Address - Phone:714-420-5520
Mailing Address - Fax:
Practice Address - Street 1:10116 MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3446
Practice Address - Country:US
Practice Address - Phone:714-420-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW613265581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical