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Organization

IMAGINE RECOVERY COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTEN KELLY (COUNSELOR)
(419) 344-9079
Entity
Organization

Contact information

Practice address
261 W JOHNSTOWN RD STE 107, GAHANNA, OH 43230-2887
(419) 344-9079
Mailing address
261 W JOHNSTOWN RD STE 107, GAHANNA, OH 43230-2887

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0431031
OH
Enumeration date
06/22/2021
Last updated
06/22/2021
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