Irene Victoria Bautista, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

014852 Issued in NY

Practice address

368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322

Phone

(631) 533-0315

NPI assigned

Dec 10, 2020

Last updated

Sep 11, 2024By the provider in NPPES

Sex

Female

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 NY

Eligible to order & refer

• Part B services: No
• 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

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

• Sean Tendler Mental Health Counseling, P.C.

  dba North Star Mental Health Counseling Services

  • Mental Health Counselor
  • Commack, NY
  • NPI 1437626025
  Medicare reassignment NPD

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1114523479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "IRENE",
        "middle_name": "VICTORIA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baske Medical Equipment & Supply, Inc.
• Sushil Kumar Basra, MD
• Lindsay Brooke Basso, M.A.
• Bastien Wellness Medicine, PLLC
• Andrea Michele Baum, M.S.
• Virginia Anne Bavolar, MASPECIAL EDUCATION
• Job Becerra, P.T.
• Meghan Theresa Becker
• Loraine T Bedoya, RPH
• Shamim A Begum, MD

• Mental Health Counselor in Commack, NY
• Providers in Commack, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.