Provider Demographics
NPI:1942032669
Name:IMAGINATION FOR BEING COUNSELING LLC
Entity type:Organization
Organization Name:IMAGINATION FOR BEING COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:EMILY
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:423-505-5585
Mailing Address - Street 1:427 E COLORADO AVE # 234
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3601
Mailing Address - Country:US
Mailing Address - Phone:719-357-7764
Mailing Address - Fax:
Practice Address - Street 1:427 E COLORADO AVE # 234
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3601
Practice Address - Country:US
Practice Address - Phone:423-505-5585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty