Active NPI
Imagine Station WV LLC
- Professional Counselor
- Huntington, WV
National Provider Identifier
1508520966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- IMAGINE STATION WV LLC
- Practice address
- 709 3Rd Ave
Huntington, WV 25701-1421 - Phone
- (304) 633-7751
- NPI assigned
- Oct 22, 2021
- Organization subpart
- Yes
- Parent organization
- IMAGINATION STATION WV LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Candace D Layne, LPC
- Title
- Director
- Phone
- (304) 544-2417
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
709 3Rd Ave
Huntington, WV 25701-1421
Mailing address
709 3Rd Ave
Huntington, WV 25701-1421
Phone (304) 544-2417
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124273065 | Other | NPI NUMBER |
Other names 2
- Imagination Station WV
- Imagine Counseling Services
National Provider Directory
National Provider Directory- Part of
- Imagine Station WV LLC
Locations
709 3rd Ave
Huntington, WV 25701
Phone (304) 633-7751
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634860800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659916800000",
"number": "1508520966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 3RD AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257011421",
"telephone_number": "304-544-2417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 3RD AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257011421",
"telephone_number": "304-633-7751"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMAGINE STATION WV LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "IMAGINATION STATION WV LLC",
"enumeration_date": "2021-10-22",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A",
"authorized_official_last_name": "LAYNE",
"authorized_official_first_name": "CANDACE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "304-544-2417",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI NUMBER",
"identifier": "1124273065",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Imagination Station WV",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Imagine Counseling Services",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Imagine Counseling Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.