Organization
IMAGINE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HAINES LPC (OWNER)
(678) 654-9237
Entity
Organization
Contact information
Practice address
3225 SHALLOWFORD RD, STE 710, MARIETTA, GA 30062-1266
(678) 654-9237
Mailing address
3225 SHALLOWFORD RD, STE 710, MARIETTA, GA 30062-1266
(678) 654-9237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC006856
GA
Other
Enumeration date
06/25/2012
Last updated
11/04/2014
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