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General NPI Number Information
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NPI Number | 1790490795
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Entity Type | Organization
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Legal Business Name | REIMAGINE PSYCHOTHERAPY & CONSULTING, PLLC
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 5900 BALCONES DR STE 8160
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 541-357-6595
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 8160
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City | AUSTIN
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State | TX
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Zip | 78731-4257
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Country | US
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Telephone | 541-357-6595
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | KAREN ELIZABETH MCKENZIE-ALEXANDER
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Credential | LPC, LMHC
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Telephone | 425-563-3073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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