Provider Demographics
NPI:1194175976
Name:IMANI TRANSFORMING ASSOCIATES
Entity type:Organization
Organization Name:IMANI TRANSFORMING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LICSW
Authorized Official - Phone:301-741-7934
Mailing Address - Street 1:4329 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2110
Mailing Address - Country:US
Mailing Address - Phone:301-741-7934
Mailing Address - Fax:
Practice Address - Street 1:4329 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2601
Practice Address - Country:US
Practice Address - Phone:301-741-7934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMANI TRANSFORMING ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-13
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty