NPIMap

Organization Active NPI

Institute for Family Therapy Inc

  • Clinical Social Worker
  • Miami Lakes, FL
National Provider Identifier
1407837743
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1677 Issued in FL
Legal business name
INSTITUTE FOR FAMILY THERAPY INC
Practice address
6175 NW 153Rd St
Suite 404
Miami Lakes, FL 33014-2435
Phone
(305) 558-7400
Fax
(305) 558-6134
NPI assigned
Nov 11, 2005
Last updated
Jan 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Benjamin Mirtenbaum, MA
Title
Executive Director
Phone
(305) 558-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW1677 FL Primary

Addresses

Primary practice location

6175 NW 153Rd St
Suite 404
Miami Lakes, FL 33014-2435

Mailing address

6175 NW 153Rd St
Suite 404
Miami Lakes, FL 33014-2435
Phone (305) 558-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000586 FL Part B Supplier - Clinic/Group Practice 8123284759 Receives reassigned benefits from 2 practitioners
Practice locations: Miami Lakes, FL

National Provider Directory

National Provider Directory

Locations

6175 NW 153rd St
Ste 404
Miami Lakes, FL 33014
Phone (305) 558-7400

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1407837743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6175 NW 153RD ST",
            "address_2": "SUITE 404",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142435",
            "telephone_number": "305-558-7400",
            "fax_number": "305-558-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6175 NW 153RD ST",
            "address_2": "SUITE 404",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142435",
            "telephone_number": "305-558-7400",
            "fax_number": "305-558-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR FAMILY THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "MIRTENBAUM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "305-558-7400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.