Katherine Marie Bradish, MA, CACI, MAC, LPC
Individual provider Active NPI Professional Counselor · Mt Pleasant, SC
NPI 1275916322 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1275916322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 1127 Queensborough Blvd Ste 102
Mt Pleasant, SC 29464-5431 - Phone
- (843) 400-4089
- NPI assigned
- Jul 8, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Charleston Counseling Center PC
Practice addresses (Care Compare)
597 Old Mount Holly Rd
Suite 300
Goose Creek, SC 29445-2832
Phone (843) 501-1099
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241119001295 | SC | Practitioner - Mental Health Counselor | 1557896206 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6576 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myrtle Beach Counseling Center | Current |
Accepting new patients | |
| Charleston Counseling Center PC | Professional | Current |
Accepting new patients |
| Mt. Pleasant Psychiatry LLC | Past |
Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
597 Old Mount Holly Rd
Ste 300
Goose Creek, SC 29445
Phone (855) 900-7318
871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
1127 Queensborough Blvd Ste 102
Mt Pleasant, SC 29464-5431
Mailing address
125 N Knightsbridge CT
Goose Creek, SC 29445-7166
Phone (843) 860-9937
Other names
- Katherine Marie Douglas
Other providers in Mt Pleasant, SC
- Brittany Laine Bowler
- Tina Bowlin
- Nicola M Boyd
- Sara Elizabeth Boyd
- Susanne M. Bradford
- Ashlyn Bradley
- Mary Atmar Bradley
- Diane Lynn Brady
- Carolina Braga
- Lillian Brandt
All providers in Mt Pleasant, SC · Professional Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.