IMAGINE & CREATE THERAPY LLC (NPI# 1265079842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265079842 |
| Entity Type | Organization |
| Organization Name | IMAGINE & CREATE THERAPY LLC |
| Practice Address |
167 Main St Ste 202 Brattleboro VT 05301-3094 |
| Mailing Address |
122 Oak St Apt 1 Brattleboro VT 05301-2902 |
| Practice Telephone | 8025364067 |
| Mailing Telephone | 9257856100 |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | KRISTI NICOLE BARNES (OWNER/ THERAPIST) |
| Authorized Official Telephone | 8025364067 |
| Authorized Official Credential | LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
167 MAIN ST STE 202 |
| City | BRATTLEBORO |
| State | VT |
| Zip Code | 05301-3094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376776765 | Kristi Barnes | Social Worker | 167 Main St Ste 202, Brattleboro, VT 05301-3094 | 2009-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013575372 | Roberta M. White | Psychologist | 72 Whetstone Rd, Brattleboro, VT 05301 | 2019-06-03 |
| 1225526940 | Audrey Johnston | Nurse Practitioner | Brattleboro Family Medicine, 53 Fairview Street, Brattleboro, VT 05301 | 2018-04-27 |
| 1811349582 | Jillian Barney | Physician Assistant | 17 Belmont Ave Richards Building (1st Floor), Barttleboro, VT 05301 | 2016-07-06 |
| 1326413899 | Gabriella Neacsu Katz | Nurse Practitioner | 1860 Weatherhead Hollow Rd, Guilford, VT 05301 | 2015-12-09 |
| 1942608914 | Kathryn Peterson | Registered Nurse | 105 Winter St Apt 2, Brattleboro, VT 05301 | 2014-12-08 |
| 1558762823 | Saryn T Lauzon | Registered Nurse | 2 Maplewood Drive, Brattleboro, VT 05301 | 2014-09-05 |
| 1912248691 | Robert Joseph Stack | Counselor | 1 Linden Street, Brattleboro, VT 05301 | 2013-03-06 |
| 1053651760 | Christopher M. Deszynski | Naturopath | 73 Main St Ste 4, Brattleboro, VT 05301 | 2013-02-18 |
| 1518236355 | Christine Hamrin | Licensed Practical Nurse | 54 Spruce Street, Brattleboro, VT 05301 | 2011-12-23 |
| 1881924934 | Margrit C. Mikulis | Naturopath | 147 Orchard St, Brattleboro, VT 05301 | 2010-01-12 |
| Find all providers in zip 05301 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726098 | Washington County Mental Health Services, Inc. | Clinic/Center | 34 Barre St, Montpelier, VT 05602-3510 | 2020-07-06 |
| 1033543616 | Southern Vermont Therapeutic Riding Center | Clinic/Center | 336 River Rd, Newfane, VT 05345-9667 | 2013-08-30 |
| 1043372709 | Northeast Kingdom Human Services Inc | Clinic/Center | 181 Crawford Rd, Newport, VT 05855-6405 | 2006-12-15 |
| 1336767755 | Green Mountain Psychology Pllc | Clinic/Center | 29 Union Street, The Granary, First Floor, Brandon, VT 05733 | 2020-07-13 |
| 1841417292 | Health Care & Rehabilitation Services | Clinic/Center | 1 Hospital Ct, Suite 410, Bellows Falls, VT 05101-1489 | 2007-04-19 |
| 1699899187 | Northwestern Counseling & Support Services | Clinic/Center | 107 Fisher Pond Road, Saint Albans, VT 05478-6286 | 2007-03-19 |
| 1902930878 | Northeast Kingdom Human Services Inc Sbs | Clinic/Center | 154 Duchess St, Newport, VT 05855 | 2007-03-15 |
| 1043343700 | Northeast Kingdom Human Services Inc Mh Children | Clinic/Center | 154 Duchess St, Newport, VT 05855 | 2007-03-13 |
| City | BRATTLEBORO |
| Zip Code | 05301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.