Individual provider Active NPI

Kaitlin Marie Carlos, MA, BCBA

  • Behavior Analyst
  • Pembroke Pines, FL
National Provider Identifier
1578010575
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-22315 Issued in IN
Practice address
556 NW 208TH Way
Pembroke Pines, FL 33029-2154
Phone
(786) 246-0854
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-22315 IN Primary

Addresses

Primary practice location

556 NW 208TH Way
Pembroke Pines, FL 33029-2154

Mailing address

556 NW 208TH Way
Pembroke Pines, FL 33029-2154
Phone (786) 246-0854

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Methods LLC Behavior Analyst PastSince Apr 1, 2022 Accepting new patients
Integrative Methods LLC PastSince Sep 1, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1578010575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 NW 208TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292154",
            "telephone_number": "786-246-0854",
            "fax_number": "765-454-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 NW 208TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292154",
            "telephone_number": "786-246-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-16-22315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.