Individual provider · Type 1 NPI

Ethan Potter, LCSW

Clinical Social Worker · Springfield, MO

NPI number 1275188799 Active

Practice location

1722 S Glenstone Ave Ste H
Springfield, MO 65804-1513

Mailing address

2135 E Independence St # 1033
Springfield, MO 65804-3749

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700XNone listed
Clinical Social Worker Primary 1041C0700X2021024924 (MO)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1275188799

Ethan Potter, LCSW's National Provider Identifier is 1275188799, issued on Aug 2, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Springfield, MO. The record was last updated on Jun 27, 2024.