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General NPI Number Information
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NPI Number | 1790818649
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Entity Type | Organization
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Legal Business Name | THE IMARA CENTER,LC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 3915 CASCADE ROAD SW SUITE 205
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City | ATLANTA
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State | GA
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Zip | 30331-8522
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Country | US
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Telephone | 404-564-4796
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Fax | 866-669-0494
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Provider Business Mailing Address
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Address Line | 3915 CASCADE ROAD SW SUITE 205
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City | ATLANTA
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State | GA
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Zip | 30331-8522
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Country | US
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Telephone | 404-564-4796
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Fax | 866-669-0494
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Authorized Official
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Title or Position | CEO
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Name | MRS. SALA I. HILAIRE
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Credential | LCSW, MAC
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Telephone | 404-564-4796
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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 | CSW001980
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CSW001980
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CSW001980
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License Number State | GA
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Taxonomy #11
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW001980
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License Number State | GA
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Taxonomy #12
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | CSW001980
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License Number State | GA
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Taxonomy #13
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CSW001980
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License Number State | GA
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Taxonomy #14
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CSW001980
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License Number State | GA
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