| Imagine Therapy Pllc | |
|
15655 W Roosevelt St Ste 202 Goodyear AZ 85338-9306 | |
| (623) 337-2275 | |
| Not Available |
| Full Name | Imagine Therapy Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 15655 W Roosevelt St Ste 202, Goodyear, Arizona |
| Authorized Official Name and Position | Patricia Ann Plum (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6233372275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine Therapy Pllc Po Box 7405 Goodyear AZ 85338-0641 Ph: (623) 337-2275 | Imagine Therapy Pllc 15655 W Roosevelt St Ste 202 Goodyear AZ 85338-9306 Ph: (623) 337-2275 |
| NPI Number | 1922570878 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 05/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922570878 | NPI | - | NPPES |
| 362794 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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