Provider Demographics
NPI:1316569494
Name:LAMPEIN MARRIAGE AND FAMILY THERAPY INSTITUTE, INC.
Entity Type:Organization
Organization Name:LAMPEIN MARRIAGE AND FAMILY THERAPY INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:HARDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LICSW, QS
Authorized Official - Phone:321-465-9411
Mailing Address - Street 1:1803 PARK CENTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6216
Mailing Address - Country:US
Mailing Address - Phone:321-465-9411
Mailing Address - Fax:321-406-1426
Practice Address - Street 1:1803 PARK CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6216
Practice Address - Country:US
Practice Address - Phone:321-465-9411
Practice Address - Fax:321-406-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty