NPIMap

Organization Active NPI

Imani Counseling Service LLC

  • Mental Health Counselor
  • Lumberton, NJ
National Provider Identifier
1245652882
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC05425200 Issued in NJ
Legal business name
IMANI COUNSELING SERVICE LLC
Practice address
774 Eayrestown Road
Lumberton, NJ 08048-3100
Phone
(917) 868-2113
NPI assigned
Jan 16, 2014
Last updated
Oct 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Authorized official

Name
Mrs. Jacqueline Thomas, LCSWNPI 1780963868
Title
Owner
Phone
(917) 868-2113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 44SC05425200 NJ Primary

Addresses

Primary practice location

774 Eayrestown Road
Lumberton, NJ 08048-3100

Mailing address

774 Eayrestown Road
Lumberton, NJ 08048-3100
Phone (917) 868-2113

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539302400000",
    "number": "1245652882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 EAYRESTOWN ROAD",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080483100",
            "telephone_number": "917-868-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 EAYRESTOWN ROAD",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080483100",
            "telephone_number": "917-868-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMANI COUNSELING SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2018-10-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-868-2113",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC05425200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.