Healthcare Provider Details

I. General information

NPI: 1013408228
Provider Name (Legal Business Name): MORGAN FRANCIS BORN-AIVES LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 N FEDERAL HWY STE 170
BOCA RATON FL
33487-4908
US

IV. Provider business mailing address

9955 BAYWATER DR
BOCA RATON FL
33496-2142
US

V. Phone/Fax

Practice location:
  • Phone: 561-305-1522
  • Fax:
Mailing address:
  • Phone: 561-305-1522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: