Provider Demographics
NPI:1326584772
Name:POTTS, LINDSAY M (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:M
Last Name:POTTS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8312 S ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8900
Mailing Address - Country:US
Mailing Address - Phone:812-269-2479
Mailing Address - Fax:
Practice Address - Street 1:8312 S ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8900
Practice Address - Country:US
Practice Address - Phone:812-269-2479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007682A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical