Individual
GARY O. POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHP
Contact information
Practice address
3720 AVENUE A, SUITE E, KEARNEY, NE 68847-8169
(308) 234-5644
(308) 234-5652
Mailing address
3720 AVENUE A, SUITE E, KEARNEY, NE 68847-8169
(308) 234-5644
(308) 234-5652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2163
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470808292
MIDLANDS CHOICE
NE
05
—
47080829226
—
NE
01
—
486558000
MAGELLAN MIS
NE
01
—
84793
BC/BS
NE
Enumeration date
08/31/2006
Last updated
12/05/2008
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