Potts Psychological Services PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

POTTS PSYCHOLOGICAL SERVICES PLLC

Practice address

9205 W Russell Rd Ste 240
Las Vegas, NV 89148-1425

Phone

(702) 793-4358

Fax

(702) 793-4301

NPI assigned

Aug 12, 2020

Organization subpart

No

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

Authorized official

Name

Brian Potts, PSY-DNPI 1740610278

Title

Owner

Phone

(702) 508-2153

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Potts, PSYD, CSAC, BCBA

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1740610278
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1114538295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HONORS COURSE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891480001",
            "telephone_number": "702-508-2153",
            "fax_number": "702-793-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 W RUSSELL RD STE 240",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481425",
            "telephone_number": "702-793-4358",
            "fax_number": "702-793-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTS PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "POTTS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-508-2153",
        "authorized_official_credential": "PSY-D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740610278",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lani Rae Potter
• Lawonda Renee Potter
• Sunny Potter
• Terilyn Princess Potter
• Tina Ileen Potter
• Airis Aisha Potts
• Ann Potts, P.T.
• Brian Potts, PSYD, CSAC, BCBA
• Chalese Marie Potts
• Haliegh Jewels Potts

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.