Provider Demographics
NPI:1518564905
Name:IMU CONSULTING AND COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:IMU CONSULTING AND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INDHIRA
Authorized Official - Middle Name:MMEFRE ANIETIE
Authorized Official - Last Name:UDOFIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:336-663-2819
Mailing Address - Street 1:1948 RAY ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1826
Mailing Address - Country:US
Mailing Address - Phone:919-638-1610
Mailing Address - Fax:
Practice Address - Street 1:1948 RAY ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-1826
Practice Address - Country:US
Practice Address - Phone:919-638-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health