Penny Louise Potter, SUDCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12872-R Issued in CA

Practice address

1770 Cedar St.
Rockledge, FL 32955

Phone

(321) 890-1500

Fax

(707) 526-0527

NPI assigned

Jan 17, 2018

Last updated

Jan 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Penny Louise Treichel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Drug Abuse Alternatives Center

  dba Redwood Empire Addiction Program

  • Methadone Clinic
  • Santa Rosa, CA
  • NPI 1629289152
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1063920601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 HARMONY PLACE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "32926",
            "telephone_number": "707-280-1705",
            "fax_number": "707-526-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 CEDAR ST.",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "32955",
            "telephone_number": "321-890-1500",
            "fax_number": "707-526-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "PENNY",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "SUDCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "12872-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "TREICHEL",
            "middle_name": "LOUISE",
            "credential": "SUDCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edwin S. Pont, M.D.
• Melinda L Poole, LMHC,CAP
• Connie Porter-Richard, LMHC
• Christine Ann Posada, M.A.
• Positive Behavioral Outcomes Inc (ABC Behavioral Services INC)
• Angela K Potucek
• Christy Lynne Powell, APRN
• Darin Pranzoni, PT, ATC
• Premier Orthotics & Prosthetics, LLC
• Premium Edge, LLC (Alura by Inspired Living)

• Addiction (Substance Use Disorder) Counselor in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.