Provider Demographics
NPI:1386860856
Name:CLINICAL & FORENSIC INSTITUTE
Entity Type:Organization
Organization Name:CLINICAL & FORENSIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:JD, PHD
Authorized Official - Phone:954-434-8006
Mailing Address - Street 1:4801 S UNIVERSITY DR
Mailing Address - Street 2:SUITE 301-EAST
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3839
Mailing Address - Country:US
Mailing Address - Phone:954-434-8006
Mailing Address - Fax:954-434-0147
Practice Address - Street 1:4801 S UNIVERSITY DR
Practice Address - Street 2:SUITE 301-EAST
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3839
Practice Address - Country:US
Practice Address - Phone:954-434-8006
Practice Address - Fax:954-434-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0006490103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty