Fern Ridge Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-1090 Issued in WY

Legal business name

FERN RIDGE COUNSELING, LLC

Practice address

1120 Beck Ave
Cody, WY 82414-3624

Phone

(307) 578-7601

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Neisha M Potter, LCSWNPI 1275997470

Title

Owner, Therapist

Phone

(307) 578-7601

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 2

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

• Neisha Potter, LCSW

  • Clinical Social Worker
  • Cody, WY
  • NPI 1275997470
  Medicare reassignment Authorized official
• Natia Potter, M.D.,

  • Endocrinology, Diabetes & Metabolism Physician
  • Mountain Top, PA
  • NPI 1245463306
  NPD (past)

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1124521547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BECK AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143624",
            "telephone_number": "307-250-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BECK AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143624",
            "telephone_number": "307-578-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN RIDGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "NEISHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "307-578-7601",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149339600",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143514100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Fallon, LCSW
• Irene Farlow
• Ashley Fauber
• Sterling T. Fenwick, PA-C
• Amanda Grey Ferguson, BS
• Kari Finley, LCSW, PH.D.
• Vicki Susan Gill Finley
• Rand Flory, M.D.
• Gregory Alan Flury, PA-C
• Laura Forcella Spiering, LCSW

• Clinical Social Worker in Cody, WY
• Providers in Cody, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.