MEDICARE: INSTITUTE FOR HUMAN POTENTIAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	FL MH 6594	FL
2	1041C0700X	Clinical Social Worker	SW 3887	FL

General Provider Information

NPI Number	:	1295714509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE FOR HUMAN POTENTIAL, INC

Provider Business Mailing Address
First Line	:	19501 NE 10TH AVE
Second Line	:	SUITE 305
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-3576
Country	:	US
Telephone Number	:	305-653-1716
Fax Number	:	305-653-7040

Provider Business Practice Location Address
First Line	:	19501 NE 10TH AVE
Second Line	:	SUITE 305
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-3576
Country	:	US
Telephone Number	:	305-653-1716
Fax Number	:	305-653-7040

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEBORAH SALAND
Credential	:	PSYD, LCSW
Telephone Number	:	305-653-1716

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	09/11/2025

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