Amanda Potter, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60628635 Issued in WA

Practice address

5380 Maxwelton Rd
Langley, WA 98260-9521

Phone

(360) 221-4800

NPI assigned

Aug 28, 2023

Last updated

Aug 28, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1427833532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 MAXWELTON RD",
            "city": "CLINTON",
            "state": "WA",
            "postal_code": "982368608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 MAXWELTON RD",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "982609521",
            "telephone_number": "360-221-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "AMANDA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60628635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia Perasso Blackwell, LMHC
• Amy L Peterson, LMHCA
• Frank G Ploof, DDS
• Carrie Melissa Pope, LICSW
• Christopher Jason Porter, MS, LMHC, MHP, NCC
• Marian Quarrier
• Solaris Rai, LMT
• Charlene Lynn Ray, M.S.W.
• Maureen Ann Roach, LICSW
• Robert M. Giswold, DDS (Saratoga Dental)

• Clinical Social Worker in Langley, WA
• Providers in Langley, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.