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General NPI Number Information
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NPI Number | 1619584307
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Entity Type | Organization
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Legal Business Name | HOPE ABUNDANCE BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 09/26/2020
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1816 E OAKLAND PARK BLVD APT 61
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1118
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Country | US
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Telephone | 954-560-4279
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Fax | 954-522-5174
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Provider Business Mailing Address
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Address Line | 1314 E LAS OLAS BLVD STE 1590
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2334
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Country | US
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Telephone | 954-560-4279
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IMANI ARIEL WILLIAMS-EPHRIAM
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Credential | MSW LCSW QS
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Telephone | 954-560-4279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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