Individual provider Active NPI

Kenneth Charles Potts, LCPC, LMFT, LSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1225120884
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1819 Bay Scott Cir Ste 109
Naperville, IL 60540-1130
Phone
(630) 357-2456
Fax
(630) 357-2482
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL
Clinical Social Worker 1041C0700X IL Primary
Marriage & Family Therapist 106H00000X IL

Addresses

Primary practice location

1819 Bay Scott Cir Ste 109
Naperville, IL 60540-1130

Mailing address

1819 Bay Scott Cir Ste 109
Naperville, IL 60540-1130
Phone (630) 357-2456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180-000534ILMDProfessional Counselor
150-001555ILMDClinical Social Worker
166-000182ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Interfaith Counseling Center Inc. PastSince Jul 2, 2012 Accepting new patients
Samaritan Counseling Center Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1225120884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401130",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY SCOTT CIR STE 109",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605401130",
            "telephone_number": "630-357-2456",
            "fax_number": "630-357-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCPC, LMFT, LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.