Provider Demographics
NPI:1295714509
Name:INSTITUTE FOR HUMAN POTENTIAL, INC
Entity type:Organization
Organization Name:INSTITUTE FOR HUMAN POTENTIAL, INC
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:305-653-1716
Mailing Address - Street 1:19501 NE 10TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3576
Mailing Address - Country:US
Mailing Address - Phone:305-653-1716
Mailing Address - Fax:305-653-7040
Practice Address - Street 1:19501 NE 10TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-3576
Practice Address - Country:US
Practice Address - Phone:305-653-1716
Practice Address - Fax:305-653-7040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL MH 6594101YM0800X
FLSW 38871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty