Therese Potocki, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0007514 Issued in OH

Practice address

1744 Payne Ave
Cleveland, OH 44114-2910

Phone

(216) 361-8640

NPI assigned

Apr 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serenity Now Therapy LLCGroup PAC ID 7416470885, 2 clinicians

Lifeguide Health LLCGroup PAC ID 3678988953, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifeguide Health LLC

  • Mental Health Counselor
  • North Olmsted, OH
  • NPI 1225628605
  Medicare reassignment Care Compare group NPD
• Serenity Now Therapy LLC

  • Clinical Social Worker
  • Westlake, OH
  • NPI 1013734144
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1972958015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-361-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-361-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTOCKI",
        "first_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0007514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather C Potemry, QMHS CMS
• Kara Michele Poth, LPCC-S, LICDC-CS
• Michael Paul Potisuk, LSW
• Pooja Potluri
• Saipriya Choudary Potluri
• Brian James Potocnik
• James R. Potocnik, D.D.S.
• Mallory R Potondi, RN, BSN
• Cynthia K Potter, CNP
• Jordan Potter, PHD

• Clinical Social Worker in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.