MEDICARE: KAITLYN LINK LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	P126400	NY

General Provider Information

NPI Number	:	1255173829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN LINK LMHC

Provider Business Mailing Address
First Line	:	29 GREENPORT AVE
Second Line	:
City	:	MEDFORD
State	:	NY
Zip	:	11763-3601
Country	:	US
Telephone Number	:	631-294-5374
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 ORVILLE DR
Second Line	:
City	:	BOHEMIA
State	:	NY
Zip	:	11716-2534
Country	:	US
Telephone Number	:	631-294-5375
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	02/11/2026

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Directions to “ KAITLYN LINK LMHC” Practice Location

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