Provider Demographics
NPI:1336676451
Name:POTTS, LEILA LISSETTE (MS, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:LEILA
Middle Name:LISSETTE
Last Name:POTTS
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:LEILA
Other - Middle Name:LISSETTE
Other - Last Name:SALAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2423 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4543
Mailing Address - Country:US
Mailing Address - Phone:540-922-1110
Mailing Address - Fax:775-392-1245
Practice Address - Street 1:212 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3626
Practice Address - Country:US
Practice Address - Phone:703-870-3880
Practice Address - Fax:775-392-1245
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133003905103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30018042700001Medicaid