Organization
GARY POTTER COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY POTTER LIMHP (OWNER)
(308) 236-0726
Entity
Organization
Contact information
Practice address
2811 30TH AVE, KEARNEY, NE 68845-4036
(308) 237-6865
Mailing address
2811 30TH AVE, KEARNEY, NE 68845-4036
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1010
NE
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
1010
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026315700
—
NE
Enumeration date
05/03/2013
Last updated
09/26/2016
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