Provider Demographics
NPI:1427638048
Name:BRAUDIS, ABIGAIL GRACE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:GRACE
Last Name:BRAUDIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:GRACE
Other - Last Name:POUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12831 BANYAN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-2802
Mailing Address - Country:US
Mailing Address - Phone:919-961-6590
Mailing Address - Fax:
Practice Address - Street 1:12831 BANYAN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-2802
Practice Address - Country:US
Practice Address - Phone:919-961-6590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW238331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical