Active NPI
Leslie Ann Potter, LCPC
- Professional Counselor
- Columbia, MD
National Provider Identifier
1649298514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 83613
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7988815 | Other | MD | AETNA |
| T541-0075 | Other | MD | CAREFIRST BCBS |
| 889628-01 | Other | MD | CAREFIRST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 83613 | MD | MD | Professional 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.