Provider Demographics
NPI:1508183278
Name:POTTER, LORI BATES (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:BATES
Last Name:POTTER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 W CHAPEL HILL ST
Mailing Address - Street 2:SUITE 908
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3616
Mailing Address - Country:US
Mailing Address - Phone:919-419-3474
Mailing Address - Fax:919-419-9353
Practice Address - Street 1:411 W CHAPEL HILL ST
Practice Address - Street 2:SUITE 908
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3616
Practice Address - Country:US
Practice Address - Phone:919-419-3474
Practice Address - Fax:919-419-9353
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional