Provider Demographics
NPI:1215796925
Name:ABRAHAM, ABIGAYIL (LMHC)
Entity type:Individual
Prefix:MS
First Name:ABIGAYIL
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E TOWN PL STE 110G
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-2726
Mailing Address - Country:US
Mailing Address - Phone:904-402-7663
Mailing Address - Fax:
Practice Address - Street 1:101 E TOWN PL STE 110G
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-2726
Practice Address - Country:US
Practice Address - Phone:904-402-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health