Organization Active NPI

Imagine U

  • Addiction (Substance Use Disorder) Counselor
  • Highland Park, MI
National Provider Identifier
1780224725
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
IMAGINE U
Practice address
62 Massachusetts St # 3
Highland Park, MI 48203-3537
Phone
(313) 870-7893
NPI assigned
Jan 7, 2020
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Annette Dumas
Title
Director
Phone
(313) 870-7893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

62 Massachusetts St # 3
Highland Park, MI 48203-3537

Mailing address

6415 Sadie LN
Van Buren TWP, MI 48111-5260
Phone (313) 870-7893

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1780224725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 SADIE LN",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481115260",
            "telephone_number": "313-870-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MASSACHUSETTS ST # 3",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033537",
            "telephone_number": "313-870-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE U",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "DUMAS",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-870-7893"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.