Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kaitlin M Petrillo, CLC

Individual provider Counselor · NPI 1558090860

Kaitlin M Petrillo, CLC is a Counselor in Ronkonkoma, New York. Practices as a sole proprietor. Licensed in Massachusetts and New York.

Licensed in
MA, NY
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

18 Borman Ct
Ronkonkoma, NY 11779-1981
Phone: (631) 219-4992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Lactation Consultant (Non-RN) (primary) Taxonomy 174N00000X · Licence 341362 (NY)
Counselor Taxonomy 101Y00000X · Licence 341362 (MA)

Record details

NPI number1558090860
Entity typeIndividual (Type 1)
GenderFemale
Credentials CLC
Sole proprietorYes
NPI enumeratedJune 10, 2022
Last updated in NPPESAugust 22, 2022
Certification dateAugust 22, 2022
Mailing address18 Borman Ct, Ronkonkoma, NY 11779-1981

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