Healthcare Provider Details

I. General information

NPI: 1669388096
Provider Name (Legal Business Name): RELATIONSHIP REIMAGINED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6734 N 13TH PL
PHOENIX AZ
85014-1118
US

IV. Provider business mailing address

6734 N 13TH PL
PHOENIX AZ
85014-1118
US

V. Phone/Fax

Practice location:
  • Phone: 646-725-8081
  • Fax:
Mailing address:
  • Phone: 646-725-8081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. IGOR MEYSTELMAN
Title or Position: MANAGING MEMBER
Credential: LAMFT
Phone: 646-725-8081