Imago Life Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

IMAGO LIFE COUNSELING, LLC

Practice address

8237 Thouron Ave
Philadelphia, PA 19150-2018

Phone

(717) 602-9023

Fax

(902) 216-8269

NPI assigned

Oct 18, 2024

Last updated

Oct 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosanne G Johnson, LPCNPI 1457351603

Title

Owner/Therapist

Phone

(717) 602-9023

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Rosanne G Johnson, LPC

  • Professional Counselor
  • Harrisburg, PA
  • NPI 1457351603
  NPD Authorized official

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1275354664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 S PROGRESS AVE STE 3A",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094636",
            "telephone_number": "717-602-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8237 THOURON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191502018",
            "telephone_number": "717-602-9023",
            "fax_number": "902-216-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGO LIFE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROSANNE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "717-602-9023",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LPC LICENSE",
            "identifier": "PC001128",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.