Provider Demographics
NPI:1134833585
Name:IMPERIAL COUNSELING LLC
Entity type:Organization
Organization Name:IMPERIAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRINCESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-252-7059
Mailing Address - Street 1:237 LOOKOUT PL
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-8433
Mailing Address - Country:US
Mailing Address - Phone:321-249-2712
Mailing Address - Fax:321-203-2512
Practice Address - Street 1:237 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8433
Practice Address - Country:US
Practice Address - Phone:321-249-2712
Practice Address - Fax:321-203-2512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty