Katherine Brooks Bautista, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

15717 Issued in NC

Practice address

1333 S Dickinson Dr Unit 200
Leland, NC 28451-6434

Phone

(910) 667-3000

NPI assigned

Jun 3, 2015

Last updated

Jun 19, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Novant Health Medical Group Coastal Region, LLC

  dba NHMGCR Cape Fear Heart

  • Cardiovascular Disease Physician
  • Wilmington, NC
  • NPI 1649865791
  Medicare reassignment Care Compare group
• Phoenix Programs of Florida, Inc. Dba Phoenix Houses of Florida, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tampa, FL
  • NPI 1477949303
  NPD (past)

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1962882126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S DICKINSON DR UNIT 200",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284516434",
            "telephone_number": "910-667-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-667-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 W Waters Ave",
            "address_2": "#404",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336341229",
            "country_code": "US",
            "telephone_number": "813-881-1000 x6624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Scotts Hill Medical Dr.",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "28411",
            "country_code": "US",
            "telephone_number": "910-662-1730",
            "fax_number": "910-662-1739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KATHERINE",
        "middle_name": "BROOKS",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "15717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699355206",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• B&a Care Ride LLC
• Caitlin Shafer Baker, DDS
• Claudia Ann Basile, P.T.
• Batish Medical Services PLLC (Batish Family Medicine)
• Sanjay Batish, MD
• Beach Brain PLLC
• Beach Brain PLLC
• Beachstar Healthcare LLC (BrightStar of Brunswick/New Hanover)
• Raymond Tyler Beaman, PA-C
• Benchmark Physical Therapy of NC, LLC

• Mental Health Counselor in Leland, NC
• Providers in Leland, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.