Deanna L Barthlow-Potkanowicz, PH.D.
Individual provider Active NPI Clinical Psychologist · Indianapolis, IN
NPI 1619225612 · NPPES record last updated Aug 8, 2025
Key facts
- NPI
- 1619225612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 20041844A (IN)
- Practice address
- 402 N Blackford St, LD 124
Indianapolis, IN 46202-3217 - Phone
- (317) 278-2515
- NPI assigned
- Aug 22, 2012
- Reactivated
- Aug 7, 2025
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041844A | IN | MD | Clinical Psychologist |
| 6265 | OH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6265 | OH | |
| Clinical Psychologist | 103TC0700X | 20041844A | IN | Yes |
Addresses
Primary practice location
402 N Blackford St, LD 124
Indianapolis, IN 46202-3217
Mailing address
402 N Blackford St, LD 124
Indianapolis, IN 46202-3217
Phone (317) 278-2515
Other names
- Deanna L Potkanowicz
Other providers in Indianapolis, IN
- Andrew Robert Bartels
- Kayla Bartels
- Kaylie Bartels
- Selena Bartelson-Andrews
- Kelsey Jean Barth
- Tyler Ryan Barthlow
- Joseph Bartholomew
- Edward A Bartkus II
- Antonia Bartlett
- April Beverly Bartlett
All providers in Indianapolis, IN · Clinical Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.