Individual provider Active NPI

Leslie Ann Potter, LCPC

  • Professional Counselor
  • Columbia, MD
National Provider Identifier
1649298514
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
83613 Issued in MD
Practice address
10451 Twin Rivers Road
Columbia, MD 21044
Phone
(410) 997-3557
Fax
(410) 964-1791
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 83613 MD Primary

Addresses

Primary practice location

10451 Twin Rivers Road
Columbia, MD 21044

Mailing address

4623 Falls Rd
Baltimore, MD 21209-4914
Phone (410) 366-1980

Other identifiers 3

IdentifierTypeStateIssuer
7988815OtherMDAETNA
T541-0075OtherMDCAREFIRST BCBS
889628-01OtherMDCAREFIRST

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
83613MDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1649298514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094914",
            "telephone_number": "410-366-1980",
            "fax_number": "410-366-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10451 TWIN RIVERS ROAD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-997-3557",
            "fax_number": "410-964-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "83613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7988815",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "T541-0075",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "889628-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.