MEDICARE: CYNTHIA POTTER MA, LISAC, CSP, NCC

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	101YM0800X	Mental Health Counselor	155307	AZ
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	155307	AZ

General Provider Information

NPI Number	:	1841705043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA POTTER MA, LISAC, CSP, NCC

Provider Business Mailing Address
First Line	:	10630 N THUNDER HILL PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85737-7006
Country	:	US
Telephone Number	:	520-954-5454
Fax Number	:

Provider Business Practice Location Address
First Line	:	10630 N THUNDER HILL PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85737-7006
Country	:	US
Telephone Number	:	520-954-5454
Fax Number	:

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

Provider Enumeration Date	:	12/10/2017
Last Update Date	:	02/25/2025

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