Provider Demographics
NPI:1144081993
Name:BARABAS, KAELYN
Entity type:Individual
Prefix:
First Name:KAELYN
Middle Name:
Last Name:BARABAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12609 JILLIAN CIR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-5004
Mailing Address - Country:US
Mailing Address - Phone:727-744-1501
Mailing Address - Fax:
Practice Address - Street 1:12609 JILLIAN CIR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-5004
Practice Address - Country:US
Practice Address - Phone:727-744-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health