Santa Selena Martin-Bautista, SUDPT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

61358497 Issued in WA

Practice address

506 W. Franklin Street
Shelton, WA 98584-3517

Phone

(360) 427-5232

Fax

(360) 427-5006

NPI assigned

Nov 2, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• New Directions Counseling, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Shelton, WA
  • NPI 1083825764
  NPD
• New Directions Counseling, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chehalis, WA
  • NPI 1356551717
  NPD

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1710694450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-740-4380",
            "fax_number": "360-740-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W. FRANKLIN STREET",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985843517",
            "telephone_number": "360-427-5232",
            "fax_number": "360-427-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-BAUTISTA",
        "first_name": "SANTA",
        "middle_name": "SELENA",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "61358497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina T Maleney, LMHC
• Lisa J Mallott, R.PH.
• Kaci Marsh
• Michael Marshall
• Carey R Martens, DO
• Andrea N Martin, M.D.
• Erin Kim Martin, LISW-S, LICDC
• Erin Martinache, LICSW
• Mary M Knight School District
• Mason Co FPD 11

• All providers in Shelton, WA
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.