| Potts Psychological Services Pllc | |
|
9205 W Russell Rd Ste 240 Las Vegas NV 89148-1425 | |
| (702) 793-4358 | |
| (702) 793-4301 |
| Full Name | Potts Psychological Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9205 W Russell Rd Ste 240, Las Vegas, Nevada |
| Authorized Official Name and Position | Brian Potts (OWNER) |
| Authorized Official Contact | 7025082153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Potts Psychological Services Pllc 145 Honors Course Dr Las Vegas NV 89148-0001 Ph: (702) 508-2153 | Potts Psychological Services Pllc 9205 W Russell Rd Ste 240 Las Vegas NV 89148-1425 Ph: (702) 793-4358 |
| NPI Number | 1114538295 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Certification Date | 08/12/2020 |
| Medicare PECOS PAC ID | 5092132605 |
|---|---|
| Medicare Enrollment ID | O20200827002550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114538295 | NPI | - | NPPES |
| 1740610278 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brian T Potts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740610278 PECOS PAC ID: 8628314101 Enrollment ID: I20190104002125 |
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