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General NPI Number Information
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NPI Number | 1437083771
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Entity Type | Organization
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Legal Business Name | IMAGINE ARTS AND FAMILY THERAPY INC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 11238 VISTA AVE
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City | GRASS VALLEY
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State | CA
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Zip | 95945-4849
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Country | US
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Telephone | 530-277-5508
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 431
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City | NEVADA CITY
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State | CA
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Zip | 95959-0431
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Country | US
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Telephone | 530-277-5508
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELLEE ANN SEPKO
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Credential | LMFT
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Telephone | 530-277-5508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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