# IMAGINE STATION WV LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IMAGINATION STATION WV LLC
- **Other names:** Imagination Station WV, Imagine Counseling Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508520966
- **Legal business name:** IMAGINATION STATION WV LLC
- **Authorized official:** CANDACE D LAYNE LPC (DIRECTOR)
- **Authorized official phone:** (304) 544-2417

## Contact information

- **Practice address:** 709 3RD AVE, HUNTINGTON, WV 25701-1421
- **Practice address phone:** (304) 633-7751
- **Mailing address:** 709 3RD AVE, HUNTINGTON, WV 25701-1421
- **Mailing address phone:** (304) 544-2417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/22/2021
- **Last updated:** 08/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1124273065 | NPI NUMBER | — |