Individual provider Active NPI

Amanda M Potter, CADC, MHRT-C

  • Addiction (Substance Use Disorder) Counselor
  • Windham, ME
National Provider Identifier
1609769421
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
AD9046 Issued in ME
Practice address
13 Birchwood Ave
Windham, ME 04062-5125
Phone
(207) 572-6705
NPI assigned
May 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Poetry Therapist 102X00000X
Behavior Technician 106S00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X AD9046 ME Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

13 Birchwood Ave
Windham, ME 04062-5125

Mailing address

13 Birchwood Ave
Windham, ME 04062-5125
Phone (207) 572-6705

Other practice location 1

13 Birchwood Ave
Windham, ME 04062-5125
Phone (207) 572-6705

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
AD9046MEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1609769421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BIRCHWOOD AVE",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625125",
            "telephone_number": "207-572-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 BIRCHWOOD AVE",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625125",
            "telephone_number": "207-572-6705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 Birchwood Ave",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "ME",
            "postal_code": "040625125",
            "country_code": "US",
            "telephone_number": "207-572-6705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "CADC, MHRT-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "102X00000X",
            "taxonomy_group": "",
            "desc": "Poetry Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "AD9046",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.