Imagine Life, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

IMAGINE LIFE, LLC

Practice address

360 Central Ave Ste 800
Saint Petersburg, FL 33701-3984

Phone

(727) 939-5037

NPI assigned

Oct 18, 2018

Organization subpart

No

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

Authorized official

Name

Amanda Pratt, LCSWNPI 1548782725

Title

Owner/ Therapist

Phone

(727) 939-5037

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Pratt, LCSW

  • Clinical Social Worker
  • Saint Petersburg, FL
  • NPI 1548782725
  Medicare reassignment NPD Authorized official
• Eric Schleich, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
  • NPI 1306275185
  NPD (past)

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1467928390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 CENTRAL AVE STE 800",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013984",
            "telephone_number": "727-939-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CENTRAL AVE STE 800",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013984",
            "telephone_number": "727-939-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/ THERAPIST",
        "authorized_official_telephone_number": "727-939-5037",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adetoluwa Emmanuel Ijidakinro, MD
• Ramona Nicoleta Ilie, MD
• Michael James Iliff, ARNP
• Stacey Elizabeth Illikal, OD
• VA Im, ARNP-C
• Imagine You New
• Camille Christelle Imbo Nloga
• Christian Imensek, MD
• Imperial Livng Inc
• In Light Acupuncture & Herbology LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.