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ETHAN POTTER LCSW
NPI 1275188799
Social Worker - Clinical in Springfield, MO

Active since August 02, 2019PECOS EnrolledAccepts Medicare Assignment
1722 S GLENSTONE AVE STE H, SPRINGFIELD, MO 65804(417) 224-7806 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 27, 2024, Nov 17, 2022, Jun 8, 2022 and 2 more (5 updates tracked since 2019).

About Ethan Potter Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN POTTER LCSW (NPI 1275188799) is an individual clinical provider in Springfield, Missouri, licensed in Missouri (2021024924) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1275188799
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameETHAN POTTERCredential: LCSW
Location Address1722 S GLENSTONE AVE STE HSpringfield, MO 65804-1513
Mailing Address2135 E Independence St # 1033Springfield, MO 65804-3749 · (417) 224-7806
Phone(417) 224-7806
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 2, 2019
Last NPPES UpdateJune 27, 20245 updates tracked since enumeration
NPPES CertifiedJune 27, 2024
✔ NPI 1275188799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MO · 2021024924
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1722 S GLENSTONE AVE STE H, Springfield, MO 65804
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Potter Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012386493
PECOS Enrollment IDI20221206003051
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $52.28 – $161.24
Typical copayment $0.00 (range $13.07 – $40.31)
Most-billed visit code NA
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANDREA GUADALUPE GONZALES LPC, MS, NBCC
Counselor (Mental Health)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 929-1240
MS. JUDY MARIE DUERKOP M.S.
Counselor (Mental Health)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (471) 881-9518
MRS. JULIE PARTIN L.C.S.W.
Social Worker (Clinical)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 881-9518
QUIET STRENGTH COUNSELING, LLC
Counselor (Professional)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 501-4938
KERRI ELISE TILLMAN MS PLPC NCC
Counselor
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 316-0863
WHEELHOUSE THERAPY, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 543-3043
MRS. CRISTI LEATHERS MA, LPC, NCC
Counselor (Professional)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 501-7440
ROOT & RISE THERAPY
Social Worker (Clinical)
1722 S GLENSTONE AVE STE H
SPRINGFIELD, MO 65804
Greene County (417) 813-0506

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Potter's NPI number?

The NPI number for Ethan Potter is 1275188799. It was assigned to this individual provider in the NPPES registry on August 2, 2019.

Where is Ethan Potter located?

Ethan Potter practices at 1722 S Glenstone Ave Ste H, Springfield, MO 65804. The listed phone number is (417) 224-7806.

What is Ethan Potter's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ethan Potter enrolled in Medicare?

Yes. Ethan Potter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ethan Potter accept?

Health plans from Medica, Oscar Insurance Company and UnitedHealthcare list Ethan Potter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Potter was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.