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Provider Information for 1932426517


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Ms. KATHERINE JEANE POTTS LMSW


Sex: Female

NPI: 1932426517
Last Updated: 2022-04-08
Certification Date: 2022-04-08

Details

NameValue
NPI1932426517
Enumeration Date2010-04-22
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1130 PARKER ST APT 116
DETROIT, MI 48214-2680
United States

Phone: 734-855-9275 | Fax:
 
Primary Practice Address 4081 CHESTER DR.
YPSILANTI, MI 48197-1521
United States

Phone: 734-855-9275 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalMI6801086421