Individual provider Active NPI

Gretchen Potter, LPCC

  • Mental Health Counselor
  • Farmington, NM
National Provider Identifier
1629392162
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0131611 Issued in NM
Practice address
871 Andrea Dr
Farmington, NM 87401-6726
Phone
(505) 566-4545
NPI assigned
Mar 25, 2010
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0131611 NM Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

871 Andrea Dr
Farmington, NM 87401-6726

Mailing address

1307 Oakwood Dr
Bloomfield, NM 87413-6376
Phone (505) 860-3365

Other practice location 1

1422 Paseo De Peralta
Santa Fe, NM 87501-4391
Phone (505) 320-9603

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gapotter@wellpath.us

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

State licenses

LicenseStateTypeSpecialty
0131611NMMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC PastSince Oct 13, 2019 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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1629392162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 OAKWOOD DR",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136376",
            "telephone_number": "505-860-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 ANDREA DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016726",
            "telephone_number": "505-566-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1422 Paseo De Peralta",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875014391",
            "country_code": "US",
            "telephone_number": "505-320-9603",
            "fax_number": "505-324-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "GRETCHEN",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0131611",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gapotter@wellpath.us",
            "affiliation": "N",
            "endpointDescription": "Secure Work Email",
            "address_1": "871 Andrea Dr",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874016726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.