Provider Demographics
NPI:1013499664
Name:ABADIA, KAITLYN CHURCHMAN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:CHURCHMAN
Last Name:ABADIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 SOW BUILDING 3021
Mailing Address - Street 2:
Mailing Address - City:DUKE FIELD
Mailing Address - State:FL
Mailing Address - Zip Code:32539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:919 SOW BUILDING 3021
Practice Address - Street 2:
Practice Address - City:DUKE FIELD
Practice Address - State:FL
Practice Address - Zip Code:32539
Practice Address - Country:US
Practice Address - Phone:850-882-8328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL113961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103457600Medicaid