Provider Demographics
NPI:1063819662
Name:HARRINGTON, KAITLIN MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:MARIE
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:MARIE
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:10317 LARAMIE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4616
Mailing Address - Country:US
Mailing Address - Phone:708-945-8552
Mailing Address - Fax:
Practice Address - Street 1:8333 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2558
Practice Address - Country:US
Practice Address - Phone:708-560-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-14-9866103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst