Potenza Psychotherapy

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

POTENZA PSYCHOTHERAPY

Practice address

10 E Mount Vernon PL
Baltimore, MD 21202-2309

Phone

(410) 929-1719

Fax

(410) 929-1719

NPI assigned

Oct 10, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Buttacavoli-Smith, PHD

Title

Owner

Phone

(410) 929-1719

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1134639628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 ROLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112032",
            "telephone_number": "253-569-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E MOUNT VERNON PL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022309",
            "telephone_number": "410-929-1719",
            "fax_number": "410-929-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTENZA PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "BUTTACAVOLI-SMITH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-929-1719",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649627480",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Postol, RN
• Michele Jennifer Postol, CRNP
• James Bennett Potash, M.D.
• John L. Potash, LCSW-C
• Alexa Poteet
• Archit Vishnu Potharazu
• Syam Kumar Potluri, B.PHARM
• Eileen R Potocki Ratajczak, PHD
• Potomac Physicians PA
• Potter LLC

• Adolescent and Children Mental Health Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Adolescent and Children Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.