Healthcare Provider Details

I. General information

NPI: 1730844192
Provider Name (Legal Business Name): JENNIFER MOREJON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15476 NW 77TH CT # 258
MIAMI LAKES FL
33016-5823
US

IV. Provider business mailing address

15476 NW 77TH CT # 258
MIAMI LAKES FL
33016-5823
US

V. Phone/Fax

Practice location:
  • Phone: 305-848-3114
  • Fax: 786-275-7079
Mailing address:
  • Phone: 305-848-3114
  • Fax: 786-275-7079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMT3836
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: