Provider Demographics
NPI:1013697143
Name:CLAY-POTTS, ADRIAUNA (LPC)
Entity type:Individual
Prefix:
First Name:ADRIAUNA
Middle Name:
Last Name:CLAY-POTTS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1899 LAKE RD STE 123
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-6006
Mailing Address - Country:US
Mailing Address - Phone:678-896-8959
Mailing Address - Fax:678-550-1155
Practice Address - Street 1:1899 LAKE RD STE 123
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-6006
Practice Address - Country:US
Practice Address - Phone:678-896-8959
Practice Address - Fax:678-550-1155
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPC007058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional