MEDICARE: BRIGHT POTENTIAL COUNSELING

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

General Provider Information

NPI Number	:	1740987965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT POTENTIAL COUNSELING

Provider Business Mailing Address
First Line	:	1705 N SAN FRANCISCO ST
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1348
Country	:	US
Telephone Number	:	828-335-5322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 N SAN FRANCISCO ST
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86001-1348
Country	:	US
Telephone Number	:	828-335-5322
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA M SHOWS
Credential	:	LPC
Telephone Number	:	828-335-5322

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	02/08/2023

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Directions to “BRIGHT POTENTIAL COUNSELING ” Practice Location

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