Imani Taliah Harrison, MA, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180014137 Issued in IL

Practice address

701 Devonshire Dr Ste C19
Champaign, IL 61820-7352

Phone

(309) 431-5381

NPI assigned

Oct 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sankofa Healing & Wellness, PLLC

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1811649783
  NPD Authorized official
• The Vitality Center

  • Mental Health Counselor
  • Champaign, IL
  • NPI 1114701554
  NPD Authorized official

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1861968240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E TOMARAS AVE",
            "city": "SAVOY",
            "state": "IL",
            "postal_code": "618749418",
            "telephone_number": "217-255-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE C19",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207352",
            "telephone_number": "309-431-5381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 E Park St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618203862",
            "country_code": "US",
            "telephone_number": "217-741-7042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "IMANI",
        "middle_name": "TALIAH",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.014231",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014137",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180014137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura A. Harriger, A.N.P.
• Kelly Harrington, ATC
• Ashley Harris, MS
• Najee Harris, DMD
• Page M McIntyre Harris
• Kendell Harrison
• Rebecca Pauline Harrison, LCPC
• Prudence Hartwell, M.D.
• Chad R Hartz
• Keisha Passion Hasbrouck, LSW

• Mental Health Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.

Verify at the official NPI Registry.