Kaytlin Tucker

Individual provider Active NPI Behavior Technician · Lakeland, GA

NPI 1487489258 · NPPES record last updated Nov 21, 2024

Key facts

NPI
1487489258
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
32 W Main St
Lakeland, GA 31635-6835
Phone
(800) 832-9419
NPI assigned
Sep 3, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Behavioral & Developmental Consultants LLC Past
since Sep 8, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

32 W Main St
Lakeland, GA 31635-6835

Mailing address

3121 N Oak Street Ext
Valdosta, GA 31602-1099
Phone (800) 832-9419

Other providers in Lakeland, GA

All providers in Lakeland, GA · Behavior Technician in Georgia

Sources for this page

Verify at the official NPI Registry.