FUTURE IMPRESSION (NPI# 1588161350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588161350 |
| Entity Type | Organization |
| Organization Name | FUTURE IMPRESSION |
| Practice Address |
619 Sullivan Street Charlotte NC 28214 |
| Mailing Address |
P.o. Box 16695 Charlotte NC 28297 |
| Practice Telephone | 9803659879 |
| Mailing Telephone | 9803659879 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |
| Authorized Official Name | BERTINA BROADNAX (CEO) |
| Authorized Official Telephone | 9803659879 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 175T00000X | Peer Specialist | Other Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Future Impressions Inc. | 2609 Roadside Lane, Chesapeake, Virginia 23325 |
| Colorado Business Entities | Future Impressions LLC | 11708 W. Aqueduct Dr, Littleton, CO 80127 |
| Street Address |
619 SULLIVAN STREET |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104456011 | Regina Williams | Custodial Care Facility | 511 Tansy Drive, Charlotte, NC 28214 | 2020-01-20 |
| 1104473974 | Daquan Ford | Technician | 7011 Hunters Glen Drive, Charlotte, NC 28214 | 2019-08-26 |
| 1457836736 | Miracle Houses, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7827 Kerry Brook Circle, Charlotte, NC 28214 | 2018-10-02 |
| 1912481029 | Charlotte Afriyie | Behavior Technician | 2122 Sonoma Valley Drive, Charlotte, NC 28214 | 2018-09-25 |
| 1588072326 | Key Choice Counseling | Community/Behavioral Health | 2909 Berry Creek Rd., Charlotte, NC 28214 | 2014-07-24 |
| 1255751699 | Joyce Patterson Melton | Registered Nurse | 7409 Pawtuckett Rd, Charlotte, NC 28214 | 2014-04-24 |
| 1407271109 | Central Carolina Medical Clinic, Pa | Internal Medicine | 515 Little Rock Road, Charlotte, NC 28214 | 2014-03-04 |
| 1063764702 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 5917 Rowan Way, Charlotte, NC 28214 | 2012-10-04 |
| 1043569460 | Loretta Massey | Social Worker | 2202 Lisa Carole Drive, Charlotte, NC 28214 | 2012-08-30 |
| 1023327129 | Margaret Cynthia Stewart | Speech-Language Pathologist | 1805 Mt Isle Harbor Drive, Charlotte, NC 28214 | 2010-10-07 |
| Find all providers in zip 28214 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574829 | Steve Hanna Interventions | Counselor | 8101 Providence Court Ln Apt 101, Charlotte, NC 28270-2385 | 2020-10-01 |
| 1164036976 | Diamond Corbin | Counselor | 3553 N Sharon Amity Rd Ste 200, Charlotte, NC 28205-8992 | 2020-08-31 |
| 1366053035 | Triumph Therapeutic Services Pllc | Counselor | 620 Parkaire Ln Apt 1024, Charlotte, NC 28217-2492 | 2020-08-14 |
| 1407472582 | Sarah Ann Grant | Counselor | 1617 Fountain Vw, Charlotte, NC 28203-5829 | 2020-06-24 |
| 1164046728 | Kevin Thomas Egroff | Counselor | 2134 Augusta St, Charlotte, NC 28216-4603 | 2020-05-29 |
| 1861039729 | No Bounds Care Inc of Nc | Counselor | 615 E 6th St Ste 102, Charlotte, NC 28202-2918 | 2019-12-10 |
| 1174168850 | Stress Management, LLC | Counselor | 8915 Legacy Park Dr Apt C, Charlotte, NC 28269-9622 | 2019-11-17 |
| 1154964062 | Setfreesoldiers, Inc | Counselor | 4900 Providence Rd, Charlotte, NC 28226-5848 | 2019-10-23 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1518508340 | Modern Era Counseling, Pllc | Counselor | 5200 Park Rd Ste 218-d, Charlotte, NC 28209-3650 | 2019-10-02 |
| Find all providers in CHARLOTTE | ||||
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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.