Carolyn B Potts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13882 Issued in MD

Practice address

975 Solomons Island Rd N
Suite 119
Prince Frederick, MD 20678-3917

Phone

(410) 535-5400

NPI assigned

Oct 24, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Cipm, LLC

  • Adult Mental Health Clinic/Center
  • Prince Frederick, MD
  • NPI 1649421835
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1285718403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "address_2": "SUITE 119",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "address_2": "SUITE 119",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "CAROLYN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4993",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connor Elizabeth Polosky
• Laurence B Polsky, MD
• Paul V Pomilla, MD
• Nancy L Porter, LSWA
• Potomac Oral & Maxillofacial Surgery
• Stephen William Pournaras III, MD
• Rosana Emmerich Powell
• Karen Ann Prahler, CRNP
• Precision Orthopedics and Sports Medicine
• Precision Orthopedics and Sports Medicine

• Clinical Social Worker in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.