Provider Demographics
NPI:1669452652
Name:INSTITUTE FOR HUMAN POTENTIAL
Entity Type:Organization
Organization Name:INSTITUTE FOR HUMAN POTENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCSW
Authorized Official - Phone:561-620-2612
Mailing Address - Street 1:370 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5816
Mailing Address - Country:US
Mailing Address - Phone:561-620-2612
Mailing Address - Fax:561-620-2614
Practice Address - Street 1:370 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5816
Practice Address - Country:US
Practice Address - Phone:561-620-2612
Practice Address - Fax:561-620-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW38871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty