Karissa Marie Kautzman, L.P.C.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1204-6-15-22A Issued in ND

Practice address

2401 46TH Ave SE Ste 102
Mandan, ND 58554-4829

Phone

(701) 595-3626

NPI assigned

May 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Karissa Marie Bauder Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

Accepts the Medicare-approved amount as payment in full

Group practices

Trauma and Attachment Institute LLCGroup PAC ID 8426584020, 3 clinicians

Practice addresses (Care Compare)

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.

• Trauma and Attachment Institute LLC

  • Mental Health Counselor
  • Bismarck, ND
  • NPI 1710704929
  Medicare reassignment Care Compare group NPD
• Decoteau Trauma-Informed Care & Practice, PLLC

  • Psychologist
  • Bismarck, ND
  • NPI 1174890016
  Medicare reassignment NPD

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1578975173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E THAYER AVE STE 222",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014018",
            "telephone_number": "701-595-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 46TH AVE SE STE 102",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585544829",
            "telephone_number": "701-595-3626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "58501",
            "country_code": "US",
            "telephone_number": "701-222-0386",
            "fax_number": "701-751-5705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUTZMAN",
        "first_name": "KARISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-30",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1727",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "1204-6-15-22A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3000",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISSA",
            "last_name": "BAUDER",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jojo- Flourish Home and Healthcare Center LLC
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• Heather Kapella
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• Brianna Keller
• Cassandra Keller
• Leah D Keller, LMT
• Marilyn J. Keller, SLP
• Kersten Chiropractic, P.C.

• Professional Counselor in Mandan, ND
• Providers in Mandan, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.