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General NPI Number Information
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NPI Number | 1184509242
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Entity Type | Organization
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Legal Business Name | VITALIZE CONSULTING & COUNSELING LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 495 GRAND BLVD STE 206
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-1897
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Country | US
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Telephone | 850-542-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 4516 E HIGHWAY 20 # 3011
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City | NICEVILLE
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State | FL
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Zip | 32578-9755
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Country | US
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Telephone | 850-542-8525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAITLYN CHURCHMAN ABADIA
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Credential | PSYD, LCSW
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Telephone | 850-218-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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