Pawel Potylicki, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6056 Issued in SC

Practice address

2715 Colonial Dr
Columbia, SC 29203-6818

Phone

(803) 783-0303

Fax

(803) 783-0955

NPI assigned

Feb 19, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment NPD
• South Carolina Department of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbia, SC
  • NPI 1952329153
  NPD
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1295127868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-783-0303",
            "fax_number": "803-783-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-783-0303",
            "fax_number": "803-783-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTYLICKI",
        "first_name": "PAWEL",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-19",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Potter, MS, RD, CSG
• Mia Michele Potter, PHARMD
• Italya Potts
• Kelsey Potts
• Wendy B. Potts, AU.D., CCC-A
• Tinsley Moise Pou, LPC-A
• Pough Dentistry
• Makeeba Bookhart Pough, D.M.D
• Morgan Pough
• Nadine Pouncy

• Professional Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.