Individual provider Active NPI

Corey Potter, PMHNP-BC, LMHC

  • Mental Health Counselor
  • Providence, RI
National Provider Identifier
1992182414
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
APRN11020548 Issued in FL
Practice address
1 Richmond SQ Ste 300E
Providence, RI 02906-5160
Phone
(401) 349-3131
Fax
(401) 921-5109
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 20428 FL
Psychiatric/Mental Health Registered Nurse 163WP0808X RN2331123 MA
Psychiatric/Mental Health Registered Nurse 163WP0808X 9588600 FL
Mental Health Counselor 101YM0800X APRN11020548 FL Primary
Mental Health Counselor 101YM0800X 10241 MA

Addresses

Primary practice location

1 Richmond SQ Ste 300E
Providence, RI 02906-5160

Mailing address

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220830003815 FL Practitioner - Nurse Practitioner 6002290756 Reassigns benefits to 1 organization
I20250926004333 RI Practitioner - Nurse Practitioner 6002290756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

1 Richmond SQ
Suite 300E
Providence, RI 02906-5160
Phone (401) 349-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20428FLMDMental Health Counselor
APRN11020548FLMDMental Health Counselor
9588600FLMDPsychiatric/Mental Health Registered Nurse
RN2331123MAMDPsychiatric/Mental Health Registered Nurse
10241MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Mental Health CurrentSince Sep 1, 2025 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince Aug 22, 2022 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince Aug 22, 2022 Accepting new patients
Community Health Care, Inc. Addiction (Substance Use Disorder) Past Accepting new patients
HCRC PastSince Apr 20, 2021 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

4300 SW 13th St
Gainesville, FL 32608

1 Richmond Sq
Ste 300E
Providence, RI 02906
Phone (401) 481-8351

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.coreypotter@151046.advancedmd-direct.com

Organizations & group practices 5

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": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1992182414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600",
            "fax_number": "352-565-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 300E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065160",
            "telephone_number": "401-349-3131",
            "fax_number": "401-921-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "COREY",
        "credential": "PMHNP-BC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "20428",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2331123",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9588600",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "APRN11020548",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.