Provider Demographics
NPI:1902794258
Name:IMAGINE ME THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:IMAGINE ME THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEA-GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-293-9809
Mailing Address - Street 1:638 BRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3822
Mailing Address - Country:US
Mailing Address - Phone:513-293-9809
Mailing Address - Fax:
Practice Address - Street 1:638 BRUNNER DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3822
Practice Address - Country:US
Practice Address - Phone:513-293-9809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health