Potts, Nicole Renae

Potts, Nicole Renae is an individual health care provider with primary practice located at 151 Southwest Dr , Jonesboro AR 72401-5828. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Potts, Nicole Renae can be contacted via phone (870) 932-0090.

Contact Information

Primary practice address
151 Southwest Dr Jonesboro AR 72401-5828
Phone: (870) 932-0090
Fax: (870) 930-9336
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 10127-M Arkansas
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SP#1761 Arkansas
Behavioral Health & Social Service Providers / Social Worker 104100000X 10127-C Arkansas

Profile Details

NPI number 1659442093
LBN Legal business name Potts, Nicole Renae
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Feb 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659442093 NPPES
Arkansas MEDICAID 142215721
Arkansas Other SP 5W442

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