Omolola Victoria Imani, MA, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC12182 Issued in MD

Practice address

2225 N Charles St
Baltimore, MD 21218-5778

Phone

(410) 453-9553

NPI assigned

Nov 4, 2019

Last updated

Mar 7, 2022By the provider in NPPES

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

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mosaic Community Services, IncGroup PAC ID 0941289417, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mosaic Community Services, Inc.

  dba Sheppard Pratt

  • Adult Mental Health Clinic/Center
  • Timonium, MD
  • NPI 1265539142
  Medicare reassignment Care Compare group NPD
• Family Services, Inc

  • Child & Adolescent Psychiatry Physician
  • Gaithersburg, MD
  • NPI 1780641928

  DC

  Medicare reassignment NPD
• Way Station, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
  • NPI 1124490784
  Medicare reassignment NPD
• Family Services, Inc.

  dba Aspire Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gaithersburg, MD
  • NPI 1881218816
  NPD
• Mosaic Community Services, Inc

  dba Sheppard Pratt

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gaithersburg, MD
  • NPI 1710466313
  NPD
• Scott Counseling Services

  • Mental Health Counselor
  • Bowie, MD
  • NPI 1790337947
  NPD (past)

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1871137638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7603 CHERT CT",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608741",
            "telephone_number": "301-806-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185778",
            "telephone_number": "410-453-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Northview Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207162600",
            "country_code": "US",
            "telephone_number": "301-257-0894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Martin Luther King Jr Ave SE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200207024",
            "country_code": "US",
            "telephone_number": "202-547-8450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMANI",
        "first_name": "OMOLOLA",
        "middle_name": "VICTORIA",
        "name_prefix": "Miss",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "LGPC00489",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP9449",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwight D Im, MD
• Lily T Im, MD
• Matthew Alexander Iman, CRNA
• Imani House Medical Services
• Imani House Medical Services
• Sharon Imani
• Hasan Imanli, MD
• Mahrokh Imanoel
• Richard Mark Imbach, DDS
• Catherine Imbeah, CRNP

• Professional Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.