Provider Demographics
NPI:1427562859
Name:SPINK, KAITLIN JEAN (LMSW)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:JEAN
Last Name:SPINK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2681 ROCKY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4809
Mailing Address - Country:US
Mailing Address - Phone:205-945-0037
Mailing Address - Fax:205-945-0031
Practice Address - Street 1:2681 ROCKY RIDGE LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4809
Practice Address - Country:US
Practice Address - Phone:205-945-0037
Practice Address - Fax:205-945-0031
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3748G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker