MEDICARE: KARIN DELIA POTTER MA, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LH60205579	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427226505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARIN DELIA POTTER MA, LMHC

Provider Business Mailing Address
First Line	:	5317 N STEVENS ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-5232
Country	:	US
Telephone Number	:	406-855-8261
Fax Number	:	509-744-3055

Provider Business Practice Location Address
First Line	:	1312 N MONROE ST STE 139
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2623
Country	:	US
Telephone Number	:	406-855-8261
Fax Number	:	509-744-3055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	12/06/2021

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