Provider Demographics
NPI:1699981605
Name:FAMILY LIFE DESIGN, INC.
Entity type:Organization
Organization Name:FAMILY LIFE DESIGN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:WILLIG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:305-669-9224
Mailing Address - Street 1:7600 S RED RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5428
Mailing Address - Country:US
Mailing Address - Phone:305-669-9224
Mailing Address - Fax:305-669-9110
Practice Address - Street 1:7600 S RED RD
Practice Address - Street 2:SUITE 307
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5428
Practice Address - Country:US
Practice Address - Phone:305-669-9224
Practice Address - Fax:305-669-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1761106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty