Imani N Rouse, LCDC INTERN

Primary specialty

Social WorkerTaxonomy code 104100000X

License

107100 Issued in TX

Practice address

6406 Highway 78 Ste 108
Sachse, TX 75048-3276

Phone

(469) 584-9675

NPI assigned

Oct 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harbinger of Hope Marriage & Family Therapy Services, PLLC

  • Mental Health Counselor
  • McKinney, TX
  • NPI 1063054989
  NPD

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1073155982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3291",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763010291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 HIGHWAY 78 STE 108",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "750483276",
            "telephone_number": "469-584-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "IMANI",
        "middle_name": "N",
        "credential": "LCDC INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "107100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASH PAY",
            "identifier": "000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• R Irvin Morgan MD PA Pathology Associates
• Nimota Yetunde Raji
• Alaina Randolph
• Rapha Health Services Inc
• RHCS Corporation
• Thelma Rouse, PH.D.
• Rugervision LLC
• Beatrice Ruto
• Sachse Chiropractic Center, Inc.
• Sachse Family Eye Clinic, PLLC

• Social Worker in Sachse, TX
• Providers in Sachse, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.