Healthcare Provider Details

I. General information

NPI: 1871410381
Provider Name (Legal Business Name): JESSALYN HANNAH MILLER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 NW 11TH ST STE W201
HOMESTEAD FL
33030-4361
US

IV. Provider business mailing address

3100 NE 48TH ST APT 618
FORT LAUDERDALE FL
33308-4948
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-5925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: