Individual provider · Type 1 NPI

Ashanti Ida Potter

Addiction (Substance Use Disorder) Counselor · Roseburg, OR

NPI number 1174116552 Active

Practice location

2575 NW Kline St.
Roseburg, OR 97471

Call (541) 673-3504 Map

Mailing address

2575 NW Kline St
Roseburg, OR 97471-8827

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1174116552

Ashanti Ida Potter's National Provider Identifier is 1174116552, issued on Feb 16, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Roseburg, OR. The record was last updated on Feb 12, 2026.