Organization
LATCHED AT LAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAITLIN PETRILLO CLC (OWNER)
(631) 219-4992
Entity
Organization
Contact information
Practice address
136 BUCKLICK CREEK CT, SIMPSONVILLE, SC 29680-7449
(631) 219-4992
Mailing address
136 BUCKLICK CREEK CT, SIMPSONVILLE, SC 29680-7449
(631) 219-4992
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up