Kathleen Potter, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

118987 Issued in MA

Practice address

400 Amity St
Amherst, MA 01002

Phone

(413) 585-1300

NPI assigned

Mar 9, 2011

Sex

Female

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

Enrolled in MA

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Servicenet IncGroup PAC ID 6901797950, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Servicenet Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northampton, MA
  • NPI 1659314425
  Medicare reassignment Care Compare group NPD
• Coastal Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Sanford, FL
  • NPI 1154594950
  NPD (past)

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1427356815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DANIEL SHAYS HWY UNIT 6",
            "city": "BELCHERTOWN",
            "state": "MA",
            "postal_code": "010078920",
            "telephone_number": "413-627-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AMITY ST",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "01002",
            "telephone_number": "413-585-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 E Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011052506",
            "country_code": "US",
            "telephone_number": "413-827-8959",
            "fax_number": "413-827-7015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "526 W Lake Mary BVLD",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "32773",
            "country_code": "US",
            "telephone_number": "800-614-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "KATHLEEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polestar Therapy, LLC
• Polestar Therapy, LLC
• Ethan J Pope, APRN
• Jane Ellen Porter, LMHC
• Jason Dean Potash, DC
• Kelli Poulin
• Malcolm Pradia, LICSW
• Aspen Prager, LICSW
• Leo Vincent Prager, PT, DPT
• Mei Lin Pratt, MSW, LCSW

• Clinical Social Worker in Amherst, MA
• Providers in Amherst, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.