| Gary Potter Counseling Llc | |
|
2811 30th Ave Kearney NE 68845-4036 | |
| (308) 237-6865 | |
| Not Available |
| Full Name | Gary Potter Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 2811 30th Ave, Kearney, Nebraska |
| Authorized Official Name and Position | Gary Potter (OWNER) |
| Authorized Official Contact | 3082360726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Potter Counseling Llc 2811 30th Ave Kearney NE 68845-4036 Ph: () - | Gary Potter Counseling Llc 2811 30th Ave Kearney NE 68845-4036 Ph: (308) 237-6865 |
| NPI Number | 1093150047 |
|---|---|
| Provider Enumeration Date | 05/03/2013 |
| Last Update Date | 09/26/2016 |
| Medicare PECOS PAC ID | 8921546615 |
|---|---|
| Medicare Enrollment ID | O20240813001566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093150047 | NPI | - | NPPES |
| 10026315700 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1010 (Nebraska) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1010 (Nebraska) | Secondary |
| Provider Name | Gary O. Potter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326159930 PECOS PAC ID: 2567900251 Enrollment ID: I20240813001682 |
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