Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Imagine Medical Group, PA

Organization Clinical Social Worker · NPI 1821731548

Imagine Medical Group, PA is a Clinical Social Worker in Philadelphia, Pennsylvania. Works from 4 locations. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 S Juniper St Fl 3
Philadelphia, PA 19107-1316
Phone: (267) 999-9534
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 400 Renaissance Ctr Ste 2600, Detroit, MI 48243-1599 — (313) 479-0497
  • 1 Gateway Ctr Ste 2600, Newark, NJ 07102-5323 — (267) 999-9534
  • 2815 Elliott Ave Ste 100, Seattle, WA 98121-2991 — (206) 316-1106

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Clinical Social Worker Taxonomy 1041C0700X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1821731548
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Wilson — President · (814) 392-8679
Other names Innovatel Medical
NPI enumeratedApril 20, 2022
Last updated in NPPESOctober 24, 2024
Certification dateOctober 24, 2024
Mailing address228 Park Ave S, New York, NY 10003-1502

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