ASD IMPACT INC (NPI# 1366858292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366858292 |
| Entity Type | Organization |
| Organization Name | ASD IMPACT INC |
| Practice Address |
6601 Washington Ave Racine WI 53406-3923 |
| Mailing Address |
1017 Stratford Ct Racine WI 53406-7001 |
| Practice Telephone | 2628805864 |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |
| Authorized Official Name | ERRICKA BORDER (OWNER) |
| Authorized Official Telephone | 2628805864 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 128554121 | WI | Agencies |
| Street Address |
6601 WASHINGTON AVE |
| City | RACINE |
| State | WI |
| Zip Code | 53406-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912307711 | Erricka Stark | Social Worker | 6601 Washington Ave, Racine, WI 53406-3923 | 2014-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
| 1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
| 1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
| 1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
| 1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
| 1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
| 1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
| Find all providers in zip 53406 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790169522 | Hopes Center | Community/Behavioral Health | 521 6th St, Racine, WI 53403-1117 | 2015-07-10 |
| 1477894244 | Entrusted Counseling Services, LLC | Community/Behavioral Health | 2317 Webster St, Racine, WI 53403-3056 | 2013-03-04 |
| 1891030748 | Hopes Center of Racine, Inc. | Community/Behavioral Health | 506 7th St, Racine, WI 53403-1128 | 2012-12-04 |
| 1467627992 | Genesis Behavioral Services, Inc | Community/Behavioral Health | 1654 Washington Ave, Racine, WI 53403-2047 | 2008-04-25 |
| 1285039578 | Racine County Ccs | Community/Behavioral Health | 1717 Taylor Ave, Racine, WI 53403-2405 | 2014-10-29 |
| 1164834453 | Edward Mitchell | Community/Behavioral Health | 2405 Northwestern Ave # Ll15, Racine, WI 53404-2534 | 2014-05-21 |
| 1982951679 | Harvest Consulting Company, LLC | Community/Behavioral Health | 2405 Northwestern Ave, Lower Level Suite 5, Racine, WI 53404-2534 | 2012-08-13 |
| 1437423563 | Derose Family Counseling, LLC. | Community/Behavioral Health | 316 5th St, Suite 1, Racine, WI 53403-4606 | 2012-03-07 |
| 1184923203 | Transitional Living Services, Inc | Community/Behavioral Health | 3710 Douglas Ave, Racine, WI 53402-3227 | 2011-03-16 |
| 1588970206 | Wheaton Franciscan Hospital | Community/Behavioral Health | 1320 Wisconsin Ave, Racine, WI 53403-1978 | 2010-08-19 |
| Find all providers in RACINE | ||||
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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.