Provider Demographics
NPI:1043059223
Name:IMAGINE PSYCHOTHERAPY & CONSULTING, INC
Entity type:Organization
Organization Name:IMAGINE PSYCHOTHERAPY & CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:805-500-6654
Mailing Address - Street 1:1223 STONECREEK RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4656
Mailing Address - Country:US
Mailing Address - Phone:805-286-5057
Mailing Address - Fax:
Practice Address - Street 1:5276 HOLLISTER AVE STE 406
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-3097
Practice Address - Country:US
Practice Address - Phone:805-500-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty