Samantha Rose Bautista, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

015486 Issued in NY

Practice address

113 Glen Cove Ave
Glen Cove, NY 11542-3438

Phone

(516) 622-8888

NPI assigned

Apr 7, 2026

Sex

Female

Sole proprietor

No

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: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Charles Evans Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bethpage, NY
  • NPI 1972982007
  Medicare reassignment

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

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1124960224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HENNESSEY DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433828",
            "telephone_number": "516-622-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 GLEN COVE AVE",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115423438",
            "telephone_number": "516-622-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belinda Basaca, M.D
• Allison Patricia Basdavanos, CCC-SLP
• Gurbhushan Singh Basra, M.D.
• Allan Batoy, ANP
• Susan Bauman
• Ross I Bederman, DDS
• Valentina Bedoya, MD
• Jessica Belkin, OTR/L
• Sergei Belkin, MD
• Christine Bell, CAT

• Mental Health Counselor in Glen Cove, NY
• Providers in Glen Cove, 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 Apr 7, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.