Healthcare Provider Details

I. General information

NPI: 1972315497
Provider Name (Legal Business Name): INNER PEACE PSYCHOTHERAPY & PSYCHIATRIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 NE 31ST CT
POMPANO BEACH FL
33064-3650
US

IV. Provider business mailing address

PO BOX 471118
MIAMI FL
33247-1118
US

V. Phone/Fax

Practice location:
  • Phone: 954-281-2960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELE BYRD
Title or Position: CO-OWNER/MANAGING MEMBER
Credential: DNP PHMHNP-BC
Phone: 954-213-6782