Charles Potter, MA, LPCC-S
NPI 1265888259ActiveIndividual· Counselor, Mental Health· Fairfield, OH
Counselor, Mental Health (MA, LPCC-S) with Mindfully LLC, practicing in Fairfield, Ohio. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1265888259 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MA, LPCC-S |
| Sole proprietor | Yes |
| NPI issued | May 9, 2016 |
| Last updated in NPPES | Nov 18, 2025 |
| Certified by provider | Nov 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | E.1901087-SUPV | OH |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (OH) |
|---|
Education and affiliations
| Graduation year | 2013 |
|---|---|
| Medicare specialty | Mental Health Counselor |
Medical group
- Mindfully LLCDenver, CO · 62 clinicians
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