| Doctor Name: | MR. JOHN EDWARD POTTS |
| NPI Number: | 1114108776 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.C. |
| License Number: | C.0501104 |
| Business Practice Address: | 303 E Bagley Rd Berea, OH - 440172040 |
| Business Phone Number: | 4402608377 |
| Business Fax Number: | |
| Mailing Address: | 303 Bagley, BEREA |
| State: | OH |
| Postal Code: | 44017 |
| Phone Number: | 4402608377 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2007 |
| NPI Last Update Date: | 11/23/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C.0501104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |