Provider Demographics
NPI:1609151497
Name:FAMILY MATTERS COUNSELING P.A.
Entity Type:Organization
Organization Name:FAMILY MATTERS COUNSELING P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JABOUIN-MONNAY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-614-7371
Mailing Address - Street 1:2501 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4131
Mailing Address - Country:US
Mailing Address - Phone:954-614-7371
Mailing Address - Fax:
Practice Address - Street 1:2501 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4131
Practice Address - Country:US
Practice Address - Phone:954-614-7371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2501106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty