THE IMARA CENTERLC NPI 1790818649

NPI Information

NPI: 1790818649
Provider Name: THE IMARA CENTER,LC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
3915 CASCADE ROAD SW
SUITE 205
ATLANTA, GA
ZIP 30331
Phone: (404) 564-4796
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THE IMARA CENTER,LC is an addiction (substance use disorder) counselor in Atlanta, GA. THE IMARA CENTER,LC NPI is 1790818649. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3915 CASCADE ROAD SW
SUITE 205
ATLANTA, GA
ZIP 30331-522
Phone: (404) 564-4796
Fax: (866) 669-0494

The provider's authorized official is Sala I. Hilaire .
The authorized official title is Ceo and has the following contact phone number (404) 564-4796.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 3/31/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	CSW001980	GEORGIA	No
2	101YP2500X	Counselor	Professional	CSW001980	GEORGIA	No
3	103T00000X	Psychologist		CSW001980	GEORGIA	No
4	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	CSW001980	GEORGIA	No
5	103TB0200X	Psychologist	Cognitive & Behavioral	CSW001980	GEORGIA	No
6	103TC0700X	Psychologist	Clinical	CSW001980	GEORGIA	No
7	103TC1900X	Psychologist	Counseling	CSW001980	GEORGIA	No
8	103TC2200X	Psychologist	Clinical Child & Adolescent	CSW001980	GEORGIA	No
9	103TP2701X	Psychologist	Group Psychotherapy	CSW001980	GEORGIA	No
10	104100000X	Social Worker		CSW001980	GEORGIA	No
11	1041C0700X	Social Worker	Clinical	CSW001980	GEORGIA	No
12	1041S0200X	Social Worker	School	CSW001980	GEORGIA	No
13	106H00000X	Marriage & Family Therapist		CSW001980	GEORGIA	No
14	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CSW001980	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	80BBFTQ	MEDICAID	GEORGIA
2	931359420A	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	# UNDER KAISER PERMANENTE
3	Q22907	MEDICARE UPIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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