Provider Demographics
NPI:1174915771
Name:ABDIN, KAILYN GLOVER (CSW)
Entity type:Individual
Prefix:MRS
First Name:KAILYN
Middle Name:GLOVER
Last Name:ABDIN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 PAUL MORPHY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2251
Mailing Address - Country:US
Mailing Address - Phone:985-255-6719
Mailing Address - Fax:
Practice Address - Street 1:9420 LINDALE AVE STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815
Practice Address - Country:US
Practice Address - Phone:225-442-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12525104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker