Provider Demographics
NPI:1184509242
Name:VITALIZE CONSULTING & COUNSELING LLC
Entity type:Organization
Organization Name:VITALIZE CONSULTING & COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:CHURCHMAN
Authorized Official - Last Name:ABADIA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCSW
Authorized Official - Phone:850-218-3062
Mailing Address - Street 1:4516 E HIGHWAY 20 # 3011
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-9755
Mailing Address - Country:US
Mailing Address - Phone:850-542-8525
Mailing Address - Fax:
Practice Address - Street 1:300 BULLOCK BLVD
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-2737
Practice Address - Country:US
Practice Address - Phone:850-218-3062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty