Healthcare Provider Details

I. General information

NPI: 1811889173
Provider Name (Legal Business Name): KAITLIN ABIGAIL HURST LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 BEACON PKWY W STE 105
BIRMINGHAM AL
35209-3131
US

IV. Provider business mailing address

3550 GRANDVIEW PKWY APT 138
BIRMINGHAM AL
35243-1958
US

V. Phone/Fax

Practice location:
  • Phone: 205-747-0758
  • Fax:
Mailing address:
  • Phone: 256-267-9471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6987G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: