| Imagine Change Counseling And Psychotherapy, Pllc | |
|
1822 E Bluefield Ave Phoenix AZ 85022-1324 | |
| (424) 298-0560 | |
| Not Available |
| Full Name | Imagine Change Counseling And Psychotherapy, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1822 E Bluefield Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Shannon Jacobson (OWNER) |
| Authorized Official Contact | 4242980560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine Change Counseling And Psychotherapy, Pllc 1822 E Bluefield Ave Phoenix AZ 85022-1324 Ph: (424) 298-0560 | Imagine Change Counseling And Psychotherapy, Pllc 1822 E Bluefield Ave Phoenix AZ 85022-1324 Ph: (424) 298-0560 |
| NPI Number | 1649945023 |
|---|---|
| Provider Enumeration Date | 08/09/2021 |
| Last Update Date | 08/09/2021 |
| Certification Date | 08/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649945023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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