Carrie Ann Potts, LMHC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2016009405 Issued in MO

Practice address

2015 S Halliburton St
Kirksville, MO 63501-4646

Phone

(660) 665-1962

NPI assigned

Mar 9, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Carrie Yates Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Preferred Family Healthcare IncGroup PAC ID 0244256246, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Preferred Family Healthcare, Inc

  • Community/Behavioral Health Agency
  • Kirksville, MO
  • NPI 1649474206

  MO

  Medicare reassignment NPD
• Preferred Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hannibal, MO
  • NPI 1306721709
  NPD
• Preferred Family Health Care, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kahoka, MO
  • NPI 1316070212
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1124489745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844715",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641844715",
            "telephone_number": "417-761-5214",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 S HALLIBURTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014646",
            "telephone_number": "660-665-1962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Blondeau St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Keokuk",
            "state": "IA",
            "postal_code": "526325548",
            "country_code": "US",
            "telephone_number": "660-216-9964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTS",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "LMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "081255",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016009405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016009405",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081255",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "YATES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Physician Services of Missouri LLC
• Savin Balathandan Pillai, DO
• Matthew Michael Piontek
• Bradley L Polovich, PHARMD
• Sara Elizabeth Poor
• Marisa F Powers, LPN
• Pamela Pratte, LCSW
• Preferred Family Healthcare
• Preferred Family Healthcare
• Preferred Family Healthcare

• All providers in Kirksville, MO
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.