Active NPI
Alice Faye Potthast, M. ED., LMFT
- Marriage & Family Therapist
- Twin Falls, ID
National Provider Identifier
1871641324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT-2899
- Practice address
- 647 Filer Ave
Twin Falls, ID 83301-4008 - Phone
- (208) 737-9999
- Fax
- (208) 736-4400
- NPI assigned
- Jan 8, 2007
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT-2899 | ID | Primary |
Addresses
Primary practice location
647 Filer Ave
Twin Falls, ID 83301-4008
Mailing address
3949 N 2600 E
Twin Falls, ID 83301-0191
Phone (208) 736-3808
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010156782 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 000010156783 | Other | ID | REGENCE BLUE SHIELD OF ID |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT-2899 | ID | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871641324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3949 N 2600 E",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833010191",
"telephone_number": "208-736-3808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "647 FILER AVE",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833014008",
"telephone_number": "208-737-9999",
"fax_number": "208-736-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTHAST",
"first_name": "ALICE",
"middle_name": "FAYE",
"credential": "M. ED., LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "ID",
"license": "LMFT-2899",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010156782",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010156783",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.