Jalissa Doughty-Moody, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT4050 Issued in FL

Practice address

100 NW 82ND Ave Ste 305
Plantation, FL 33324-1835

Phone

(954) 903-1676

Fax

(954) 398-1338

NPI assigned

May 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651881600000",
    "number": "1730744251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NW 82ND AVE STE 305",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241835",
            "telephone_number": "954-903-1676",
            "fax_number": "954-398-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NW 82ND AVE STE 305",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241835",
            "telephone_number": "954-903-1676",
            "fax_number": "954-398-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 NW 84th Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333241807",
            "country_code": "US",
            "telephone_number": "954-903-1676 x6",
            "fax_number": "954-398-1338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHTY-MOODY",
        "first_name": "JALISSA",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-05-07",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Dorval, PHARMD
• Monica Carolina Dorvil-Bello, M.D.
• Beatriz Dostourian, MA
• Igbayilola Mariam Dosunmu, MD
• James M. Doty, MD
• Kimani Douglas
• Monique Karline Douglas, DDS
• Richard C Douglas, DDS
• Tameka Michelle Douglas, CRNA
• Kirk Dourvetakis

• Marriage & Family Therapist in Plantation, FL
• Providers in Plantation, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.