Kaitlynn M Portillo, is a
Behavior Technician based in Jacksonville, North Carolina. Kaitlynn M Portillo is licensed to practice in * (Not Available) (license number ) and her current practice location is
200 Doctors Dr Ste 200, Jacksonville, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(910) 333-0814.
NPI number for Kaitlynn M Portillo is 1063077378 and her current mailing address is 41 Pacella Park Dr, Randolph, Massachusetts. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063077378.
Healthcare Provider's Profile
Full Name | Kaitlynn M Portillo |
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Gender | Female |
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Speciality | Behavior Technician |
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Location | 200 Doctors Dr Ste 200, Jacksonville, North Carolina |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063077378
- Provider Enumeration Date: 05/02/2019
- Last Update Date: 02/17/2021
Medical Identifiers
Medical identifiers for Kaitlynn M Portillo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063077378 | NPI | - | NPPES |
110026265E | Medicaid | MA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kaitlynn M Portillo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kaitlynn M Portillo, 41 Pacella Park Dr, Randolph, MA 02368-1755 Ph: (910) 333-0814 | Kaitlynn M Portillo, 200 Doctors Dr Ste 200, Jacksonville, NC 28546-6310 Ph: (910) 333-0814 |
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