Provider Demographics
NPI:1275149148
Name:STURRUP, EBONY (LMFT, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:
Last Name:STURRUP
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7971 RIVIERA BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6447
Mailing Address - Country:US
Mailing Address - Phone:954-744-4369
Mailing Address - Fax:
Practice Address - Street 1:7971 RIVIERA BLVD STE 302
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6447
Practice Address - Country:US
Practice Address - Phone:954-744-4369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist