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

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: October 18, 2026.

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

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
Open in Google Maps ↗

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Charles Potter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mindfully, LLC
Same address
Counselor
1251 NILLES RD STE 5
Fairfield, OH 45014
  • Reassigned Medicare billing, Ohio enrollment
  • 134 clinicians in this Medicare group
NPI 1972702520 (513) 939-0300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (888) 830-0347
MS. SARA MORGAN PICKETT MA, MED., LPCC
Counselor (Professional)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300
REBECCA SWARTZENDRUBER LPCC
Counselor (Professional)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300
LOGAN CURTIS MCQUEARY LPCC
Counselor (Professional)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300
LAURA HOLMES LISW
Social Worker (Clinical)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300
ANDREW DONALD SIEGLER LPCC
Counselor (Professional)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300
ALEXIS PAIGE REESE
Counselor
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (888) 830-0347
STEPHANIE RUSSELL
Counselor (Mental Health)
1251 NILLES RD STE 5
FAIRFIELD, OH 45014
Butler County (513) 939-0300

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 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.

Where is Charles Potter located?

Charles Potter practices at 1251 Nilles Rd Ste 5, Fairfield, OH 45014. The listed phone number is (513) 939-0300.

What is Charles Potter's specialty?

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

Is Charles Potter enrolled in Medicare?

Yes. Charles 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.

Which organization bills Medicare for Charles Potter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Potter reassigns Medicare benefits to Mindfully, LLC (Fairfield, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Potter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Potter accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 6 other insurers list Charles 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 Charles Potter was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.