Healthcare Provider Details
I. General information
NPI: 1922937440
Provider Name (Legal Business Name): INDIVIDUAL, COUPLES AND FAMILY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7385 FAIRWAY DR
MIAMI LAKES FL
33014-7818
US
IV. Provider business mailing address
7385 FAIRWAY DR APT 163
MIAMI LAKES FL
33014-6812
US
V. Phone/Fax
- Phone: 786-521-2728
- Fax: 786-521-2728
- Phone: 786-521-2728
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOAN
MORTON, PHD
Title or Position: OWNER
Credential: PHD, LCCC, LCPC
Phone: 786-521-2728