Individual
MS. KIMBERLY ANN POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,, LIMHP
Contact information
Practice address
415 S 25TH ST, OMAHA, NE 68124
(402) 742-8857
(402) 477-0081
Mailing address
415 SOUTH 25TH STREET, OMAHA, NE 68124
(402) 717-5550
(402) 717-5792
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-994
NE
101YM0800X
Mental Health Counselor
114
NE
101YM0800X
Mental Health Counselor
Primary
2432
NE
101YP2500X
Professional Counselor
1330
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238599
MIDLANDS CHOICE
NE
05
—
47052851500
—
NE
05
—
47052851581
—
NE
01
—
84988
BCBS
NE
Enumeration date
11/20/2006
Last updated
06/03/2021
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