NPIMap

Organization Active NPI

Inner Imagination, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brick, NJ
National Provider Identifier
1720636723
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INNER IMAGINATION, LLC
Practice address
482 Brick Blvd Ste 2
Brick, NJ 08723-6077
Phone
(732) 705-1082
NPI assigned
Sep 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Authorized official

Name
Caitlyn Stephens, LCSWNPI 1003243528
Title
Owner
Phone
(732) 705-1082

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 Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

482 Brick Blvd Ste 2
Brick, NJ 08723-6077

Mailing address

PO Box 959
Asbury Park, NJ 07712-0959
Phone (732) 705-1082

National Provider Directory

National Provider Directory

Locations

482 Brick Blvd
Ste 2
Brick, NJ 08723
Phone (732) 705-1082

Practitioners & affiliated clinicians

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": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1720636723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077120959",
            "telephone_number": "732-705-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 BRICK BLVD STE 2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236077",
            "telephone_number": "732-705-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER IMAGINATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-705-1082",
        "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": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.