Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Samantha Rose Bautista, LMHC

Individual provider Mental Health Counselor · NPI 1124960224

MS. Samantha Rose Bautista, LMHC is a Mental Health Counselor in Glen Cove, New York. Qualified in 2022, 4 years ago. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2026
What do these letters mean?
LMHC — Licensed Mental Health Counselor
A licensed mental health counsellor; the title used in Florida, New York and Washington among others.

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Practice location Address checks out

113 Glen Cove Ave
Glen Cove, NY 11542-3438
Phone: (516) 622-8888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 015486 (NY)

Record details

NPI number1124960224
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMHC
Sole proprietorNo
NPI enumeratedApril 7, 2026
Last updated in NPPESApril 7, 2026
Certification dateApril 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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