Katherine Marie Bradish, MA, CACI, MAC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1127 Queensborough Blvd Ste 102
Mt Pleasant, SC 29464-5431

Phone

(843) 400-4089

NPI assigned

Jul 8, 2015

Last updated

Jul 21, 2022By the provider in NPPES

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

Other names 1

• Katherine Marie Douglas Former name

Medicare fee-for-service enrollment

Enrolled in SC

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Charleston Counseling Center PC

  dba Lifestance Health

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678

  Professional

  Medicare reassignment Care Compare group NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD
• Mt. Pleasant Psychiatry LLC

  • Psychiatry Physician
  • Mount Pleasant, SC
  • NPI 1013280650
  NPD (past)

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275916322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N KNIGHTSBRIDGE CT",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457166",
            "telephone_number": "843-860-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 QUEENSBOROUGH BLVD STE 102",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645431",
            "telephone_number": "843-400-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADISH",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "MA, CACI, MAC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "DOUGLAS",
            "middle_name": "MARIE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Laine Bowler, DO
• Tina Bowlin, LMT
• Nicola M Boyd
• Sara Elizabeth Boyd, WHNP
• Susanne M. Bradford, M.D.
• Ashlyn Bradley, LISW-CP
• Mary Atmar Bradley, MSP, CCC-SLP
• Diane Lynn Brady, RN
• Carolina Braga, DMD
• Lillian Brandt

• Professional Counselor in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.