| Imago Life Counseling, Llc | |
|
8237 Thouron Ave Philadelphia PA 19150-2018 | |
| (717) 602-9023 | |
| (902) 216-8269 |
| Full Name | Imago Life Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 8237 Thouron Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Rosanne G Johnson (OWNER/THERAPIST) |
| Authorized Official Contact | 7176029023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imago Life Counseling, Llc 160 S Progress Ave Ste 3a Harrisburg PA 17109-4636 Ph: (717) 602-9023 | Imago Life Counseling, Llc 8237 Thouron Ave Philadelphia PA 19150-2018 Ph: (717) 602-9023 |
| NPI Number | 1275354664 |
|---|---|
| Provider Enumeration Date | 10/18/2024 |
| Last Update Date | 10/22/2024 |
| Certification Date | 10/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275354664 | NPI | - | NPPES |
| PC001128 | Other | PA | PA LPC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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