NPIMap

Organization Active NPI

Imagine Counseling Services, LLC

  • Mental Health Counselor
  • Marietta, GA
National Provider Identifier
1619230620
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC006856 Issued in GA
Legal business name
IMAGINE COUNSELING SERVICES, LLC
Practice address
3225 Shallowford Rd
Ste 710
Marietta, GA 30062-1266
Phone
(678) 654-9237
NPI assigned
Jun 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Kathy Haines, LPC
Title
Owner
Phone
(678) 654-9237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LPC006856 GA Primary

Addresses

Primary practice location

3225 Shallowford Rd
Ste 710
Marietta, GA 30062-1266

Mailing address

3225 Shallowford Rd
Ste 710
Marietta, GA 30062-1266
Phone (678) 654-9237

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1619230620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD",
            "address_2": "STE 710",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621266",
            "telephone_number": "678-654-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD",
            "address_2": "STE 710",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621266",
            "telephone_number": "678-654-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-654-9237",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC006856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.