MR. ALBERT POTTER


Address: 5043 W. Campbell Ave., Phoenix, AZ 85031
Phone: 6232477877

MR. ALBERT POTTER (NPI# 1912237397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912237397
Entity Type Individual
Full Name MR. ALBERT POTTER
Credential L.I.S.A.C.
Practice Address 5043 W. Campbell Ave.
Phoenix
AZ 85031
Mailing Address 5049 W. Campbell Ave.
Phoenix
AZ 85031
Practice Telephone 6232477877
Practice Fax Number 6238482585
Mailing Telephone 6232477877
Mailing Fax Number 6238482585
Enumeration Date 2010-01-06
Last Update Date 2010-01-06
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
10669 AZ Behavioral Health & Social Service Providers

Office Location

Street Address 5043 W. CAMPBELL AVE.
City PHOENIX
State AZ
Zip Code 85031

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 85031

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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