Healthcare Provider Details

I. General information

NPI: 1184509242
Provider Name (Legal Business Name): VITALIZE CONSULTING & COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 GRAND BLVD STE 206
MIRAMAR BEACH FL
32550-1897
US

IV. Provider business mailing address

4516 E HIGHWAY 20 # 3011
NICEVILLE FL
32578-9755
US

V. Phone/Fax

Practice location:
  • Phone: 850-542-8525
  • Fax:
Mailing address:
  • Phone: 850-542-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KAITLYN CHURCHMAN ABADIA
Title or Position: OWNER
Credential: PSYD, LCSW
Phone: 850-218-3062