Healthcare Provider Details

I. General information

NPI: 1538760244
Provider Name (Legal Business Name): EPIPHANY COUNSELING AND PROFESSIONAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7971 RIVIERA BLVD STE 112
MIRAMAR FL
33023-6453
US

IV. Provider business mailing address

7971 RIVIERA BLVD STE 112
MIRAMAR FL
33023-6453
US

V. Phone/Fax

Practice location:
  • Phone: 954-744-4369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. EBONY STURRUP
Title or Position: OWNER
Credential: LMFT, LMHC
Phone: 954-254-9982