Potters Place, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH3284 Issued in AZ

Legal business name

POTTERS PLACE, LLC

Practice address

8629 W Roanoke Ave
Phoenix, AZ 85037-3519

Phone

(623) 848-0629

Fax

(623) 873-6127

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Ardell C Daniels

Title

Assistant Executive Officer

Phone

(623) 848-0629

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1306174115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8629 W ROANOKE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373519",
            "telephone_number": "623-848-0629",
            "fax_number": "623-873-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8629 W ROANOKE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373519",
            "telephone_number": "623-848-0629",
            "fax_number": "623-873-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTERS PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "ARDELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "623-848-0629",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH3284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Potter, RDN
• Laura Potter, LCPC
• Maryann Potter
• Michelle Potter
• Robin Potter
• Tamara I Pottker, M.D.
• Jeremy Pottle, LMSW
• Celeste E Pottorff, D.O.
• Donald M Potts, MD
• Jack Potts X, M.D.

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.