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General NPI Number Information
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NPI Number | 1598718777
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Entity Type | Individual
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Provider Name | WILLIAM HOLLIS POTTER LPC, LCAS
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 440 E COURT ST
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City | MARION
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State | NC
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Zip | 28752-1864
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Country | US
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Telephone | 828-659-8626
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Fax | 828-659-6383
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Provider Business Mailing Address
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Address Line | 2187 OAKDALE RD
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City | OLD FORT
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State | NC
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Zip | 28762-8836
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Country | US
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Telephone | 828-668-9565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 551
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4731
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License Number State | NC
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