NPIMap

Organization Active NPI

Imagine Recovery Counseling

  • Mental Health Counselor
  • Gahanna, OH
National Provider Identifier
1548839731
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
IMAGINE RECOVERY COUNSELING
Practice address
261 W Johnstown Rd Ste 107
Gahanna, OH 43230-2887
Phone
(419) 344-9079
NPI assigned
Jun 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Kristen KellyNPI 1467905075
Title
Counselor
Phone
(419) 344-9079

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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

261 W Johnstown Rd Ste 107
Gahanna, OH 43230-2887

Mailing address

261 W Johnstown Rd Ste 107
Gahanna, OH 43230-2887

Other identifiers 1

IdentifierTypeStateIssuer
0431031MedicaidOH

National Provider Directory

National Provider Directory

Locations

261 W Johnstown Rd
Ste 107
Gahanna, OH 43230
Phone (419) 344-9079

Practitioners & affiliated clinicians

Practitioners 9

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": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1548839731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 W JOHNSTOWN RD STE 107",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 W JOHNSTOWN RD STE 107",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302887",
            "telephone_number": "419-344-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE RECOVERY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "419-344-9079"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0431031",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.