CHARLES POTTER MA, LPCC-S
NPI 1265888259
Counselor - Mental Health in Fairfield, OH

Q: What is Charles Potter's NPI number?

The NPI number for Charles Potter is 1265888259. It was assigned to this individual provider in the NPPES registry on May 9, 2016.

Q: What is Charles Potter's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Charles Potter was last updated on November 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 09, 2016PECOS EnrolledAccepts Medicare Assignment

1251 NILLES RD STE 5, FAIRFIELD, OH 45014(513) 939-0300(513) 939-0310 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 18, 2025, Jun 18, 2019, May 9, 2016 (3 updates tracked since 2016).

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About Charles Potter Ma, Lpcc-s NPPES

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

CHARLES POTTER MA, LPCC-S (NPI 1265888259) is an individual mental health provider in Fairfield, Ohio, licensed in Ohio (E.1901087-SUPV) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Springfield, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1265888259

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameCHARLES POTTERCredential: MA, LPCC-S

Location Address1251 NILLES RD STE 5Fairfield, OH 45014-7205

Mailing Address1251 Nilles Rd Ste 5Fairfield, OH 45014-7205 · (513) 939-0300 · Fax (513) 939-0310

Phone(513) 939-0300

Fax(513) 939-0310

Sole ProprietorYes

Medical School CMSOtherGraduated 2013

Enumeration DateMay 9, 2016

Last NPPES UpdateNovember 18, 20253 updates tracked since enumeration

NPPES CertifiedNovember 18, 2025

✔ NPI 1265888259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in OH · E.1901087-SUPV

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

1251 NILLES RD STE 5, Fairfield, OH 45014

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Secondary Practice Location 1

Location 180 Congress St, Suite 106Springfield, MA 01104-3564 · Phone (413) 739-1611 · Fax (413) 739-1711

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Molina Healthcare and more.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

Charles Potter Ma, Lpcc-s 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 ID8527411669

PECOS Enrollment IDI20240125001358

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.

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Other Providers at the Same Location NPPES 20

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

MS. JESSICA CARAS LPC

Counselor (Professional)