Organization Name: | IMAGINE ME COUNSELING, LLC |
NPI Number: | 1740645811 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RACHELLE DELORES SMITH (CEO) |
Mailing Address: | 9100 Overland Plz Overland |
State: | MO US |
Postal Code: | 631146123 |
Phone Number: | 3147449027 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2015 |
NPI Last Update Date: | 12/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2010009689 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |