Individual provider Active NPI

Jennifer Irene Potterton, MSW LICSW

  • Clinical Social Worker
  • Longview, WA
National Provider Identifier
1295828721
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60124109 Issued in WA
Practice address
2610 Ocean Beach Hwy
Longview, WA 98632-3508
Phone
(360) 208-1778
NPI assigned
Oct 2, 2006
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW60124109 WA Primary

Addresses

Primary practice location

2610 Ocean Beach Hwy
Longview, WA 98632-3508

Mailing address

2610 Ocean Beach Hwy
Longview, WA 98632-3508
Phone (360) 208-1778

Other names 1

  • Miss Jennifer Irene Pierce Other name

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

State licenses

LicenseStateTypeSpecialty
LW60124109WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1295828721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 OCEAN BEACH HWY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323508",
            "telephone_number": "360-208-1778",
            "fax_number": "509-966-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 OCEAN BEACH HWY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323508",
            "telephone_number": "360-208-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTERTON",
        "first_name": "JENNIFER",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60124109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PIERCE",
            "middle_name": "IRENE",
            "prefix": "MISS",
            "credential": "BSW BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.