John Albert Potter III, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10766 Issued in CT

Practice address

883 Paddock Ave
Meriden, CT 06450-7044

Phone

(203) 630-5208

Fax

(203) 630-5335

NPI assigned

Oct 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: john.potter@xdr.hhchealthdirect.org

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1326680588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5208",
            "fax_number": "203-630-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "JOHN",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eboni Shanice Pope, MFTA
• Alyssa Porter, NP
• Theresa Porter, PSY
• Positive Alternatives for Children & Teens, Inc
• Nicolas Brown Potenza, BSN, RN
• Aimee L. Powers, PT
• Anca M Pralea, M.D.
• Lisa M Pranger
• Premier Dental P C
• Premier Eyecare

• Clinical Social Worker in Meriden, CT
• Providers in Meriden, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.