Provider Demographics
NPI:1700636602
Name:POTTER COUNSELING LLC
Entity Type:Organization
Organization Name:POTTER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:605-641-3232
Mailing Address - Street 1:1320 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1525
Mailing Address - Country:US
Mailing Address - Phone:605-641-3232
Mailing Address - Fax:605-644-7356
Practice Address - Street 1:1320 NORTH AVE
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1525
Practice Address - Country:US
Practice Address - Phone:605-644-7494
Practice Address - Fax:605-644-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty