Active NPI
Janette Mae Potter, MS LLP
- Intellectual & Developmental Disabilities Psychologist
- Trenton, MI
National Provider Identifier
1477021657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 6301007137
- Practice address
- 1660 Fort St
Trenton, MI 48183-2003 - Phone
- (734) 304-4159
- NPI assigned
- Nov 6, 2018
- Last updated
- Apr 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 6301007137 | MI | Primary |
Addresses
Primary practice location
1660 Fort St
Trenton, MI 48183-2003
Mailing address
23400 Allor St
Saint Clair Shores, MI 48082-1147
Phone (586) 994-0772
Other practice location 1
1660 Fort St
Trenton, MI 48183-2003
Phone (734) 304-4159
Other names 1
- Janette Mae Laburn
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007137 | MI | MD | Intellectual & Developmental Disabilities Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psygenics Inc | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1477021657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23400 ALLOR ST",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480821147",
"telephone_number": "586-994-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 FORT ST",
"city": "TRENTON",
"state": "MI",
"postal_code": "481832003",
"telephone_number": "734-304-4159"
}
],
"practiceLocations": [
{
"address_1": "1660 Fort St",
"address_purpose": "LOCATION",
"city": "Trenton",
"state": "MI",
"postal_code": "481832003",
"country_code": "US",
"telephone_number": "734-304-4159",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTTER",
"first_name": "JANETTE",
"middle_name": "MAE",
"credential": "MS LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-06",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "MI",
"license": "6301007137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANETTE",
"last_name": "LABURN",
"middle_name": "MAE",
"credential": "MS LLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Trenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.