# IMAGINE THERAPY MINDFULNESS HEALING PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669144218
- **Authorized official:** CHRISSA FLANNERY (MANAGER)
- **Authorized official phone:** (708) 337-0642

## Contact information

- **Practice address:** 708 W GRAND AVE, CHICAGO, IL 60654
- **Practice address phone:** (312) 300-2190
- **Mailing address:** 708 W GRAND AVE, CHICAGO, IL 60654
- **Mailing address phone:** (312) 300-2190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 207PH0002X | Hospice and Palliative Medicine (Emergency Medicine) Physician | — | NULL | — |
| 207PH0002X | Hospice and Palliative Medicine (Emergency Medicine) Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2021
- **Last updated:** 10/01/2021