Active NPI
Jesse Potter, M.ED., LPC, LCDC
- Professional Counselor
- Abilene, TX
National Provider Identifier
1265832109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 69219
- Practice address
- 1400 Sayles Blvd
Abilene, TX 79605-4236 - Phone
- (325) 793-4881
- NPI assigned
- Aug 28, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11807 | TX | |
| Professional Counselor | 101YP2500X | 69219 | TX | Primary |
Addresses
Primary practice location
1400 Sayles Blvd
Abilene, TX 79605-4236
Mailing address
1400 Sayles Blvd.
Abilene, TX 79605
Phone (325) 793-4881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11807 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 69219 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482796800000",
"number": "1265832109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 SAYLES BLVD.",
"city": "ABILENE",
"state": "TX",
"postal_code": "79605",
"telephone_number": "325-793-4881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 SAYLES BLVD",
"city": "ABILENE",
"state": "TX",
"postal_code": "796054236",
"telephone_number": "325-793-4881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "JESSE",
"name_prefix": "Mrs.",
"credential": "M.ED., LPC, LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-28",
"last_updated": "2016-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "11807",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "69219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.