Anne Catherine Portine- Kudlac, MA, RDT, LCADC, DRCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00121500 Issued in NJ

Practice address

19 Excelsior PL
Butler, NJ 07405-1511

Phone

(973) 557-1545

NPI assigned

Aug 8, 2012

Last updated

Aug 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1811244981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 EXCELSIOR PL",
            "city": "BUTLER",
            "state": "NJ",
            "postal_code": "074051511",
            "telephone_number": "973-557-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 EXCELSIOR PL",
            "city": "BUTLER",
            "state": "NJ",
            "postal_code": "074051511",
            "telephone_number": "973-557-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTINE- KUDLAC",
        "first_name": "ANNE",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "MA, RDT, LCADC, DRCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NJ",
            "license": "2035",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00121500",
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": "239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minaxi D Parikh, M.D.
• Andrelisa Paulino Paulino, NP
• Pediatric Arts of Northern New Jersey
• Scott M Pelcyger, O.D.
• Claudia Nathaly Perez
• Biju Raju, D.O.
• Brooke Nicole Redner I, MS, LAT, ATC
• Grace Rivera, BCBA
• Berta Rodrigues, LCSW
• Jennifer L Romalin, APN

• Addiction (Substance Use Disorder) Counselor in Butler, NJ
• Providers in Butler, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.