Individual provider Active NPI

Michael Henry Potter, MLADC

  • Addiction (Substance Use Disorder) Counselor
  • Keene, NH
National Provider Identifier
1639534480
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0179 Issued in NH
Practice address
33 West St
2ND Floor
Keene, NH 03431-3361
Phone
(603) 355-0157
Fax
(603) 355-0159
NPI assigned
Dec 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0179 NH Primary

Addresses

Primary practice location

33 West St
2ND Floor
Keene, NH 03431-3361

Mailing address

1251 US Route 10
Lempster, NH 03605-3302
Phone (603) 863-7948

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
0179NHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1639534480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 US ROUTE 10",
            "city": "LEMPSTER",
            "state": "NH",
            "postal_code": "036053302",
            "telephone_number": "603-863-7948",
            "fax_number": "603-355-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WEST ST",
            "address_2": "2ND FLOOR",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313361",
            "telephone_number": "603-355-0157",
            "fax_number": "603-355-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "credential": "MLADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.