Individual provider Active NPI

Alaina Marie Potter, LMHC

  • Mental Health Counselor
  • Lady Lake, FL
National Provider Identifier
1669245189
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22943 Issued in FL
Practice address
379 Fennell Blvd
Lady Lake, FL 32159-3185
Phone
(352) 633-5253
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH22943 FL Primary

Addresses

Primary practice location

379 Fennell Blvd
Lady Lake, FL 32159-3185

Mailing address

15033 Farm Rd
Groveland, FL 34736-9293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240524002783 FL Practitioner - Mental Health Counselor 8123460961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freedom Counseling Services, LLCGroup PAC ID 2769834340, 3 clinicians

Practice addresses (Care Compare)

379 Fennell Blvd
Lady Lake, FL 32159-3185
Phone (352) 633-5253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH22943FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Counseling Services, LLC Mental Health CurrentSince Apr 16, 2024 Accepting new patients
Orthocare Orthotics and Prosthetics Inc PastSince Nov 12, 2023 Accepting new patients

Locations

363 Fennell Blvd
Lady Lake, FL 32159
Phone (352) 633-5253

379 Fennell Blvd
Lady Lake, FL 32159
Phone (352) 633-5253

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1669245189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15033 FARM RD",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347369293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 FENNELL BLVD",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593185",
            "telephone_number": "352-633-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "ALAINA",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.