Healthcare Provider Details

I. General information

NPI: 1306111802
Provider Name (Legal Business Name): RHONDA POTTS LPC,LCAS,,LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N EUGENE ST
GREENSBORO NC
27401-2221
US

IV. Provider business mailing address

1711 TRAYWICK CT
MC LEANSVILLE NC
27301-9254
US

V. Phone/Fax

Practice location:
  • Phone: 336-389-6099
  • Fax:
Mailing address:
  • Phone: 336-707-0483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3152
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8471
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8471
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: