IMPACT CAROLINA SERVICES (NPI# 1629311063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629311063 |
| Entity Type | Organization |
| Organization Name | IMPACT CAROLINA SERVICES |
| Practice Address |
1552 Union Rd Suite C Gastonia NC 28054-5523 |
| Practice Telephone | 7048529210 |
| Practice Fax Number | 7048529211 |
| Mailing Telephone | 7048529210 |
| Mailing Fax Number | 7048529211 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-04-04 |
| Authorized Official Name | DR. JOSEPH ADEDOKUN (CEO) |
| Authorized Official Telephone | 7047322006 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
795 | NC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
C002728 | NC | Behavioral Health & Social Service Providers |
| N | 363L00000X | Nurse Practitioner | 5004878 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
5004910 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
NC 93-00472 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6003129 | 05 | |
| NC | 5004910 | 05 | |
| NC | 6111767 | 05 | |
| NC | 5004878 | 05 | |
| NC | 891036Y | 05 |
| Street Address |
1552 UNION RD SUITE C |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-5523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386682052 | Pushpa Chander | Internal Medicine | 1552 Union Rd, Suite C, Gastonia, NC 28054-5523 | 2006-06-03 |
| 1598111205 | Denise Rae Wells | Counselor | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2016-05-11 |
| 1689054025 | Kristy Yetman | Counselor | 1552 Union Rd, Gastonia, NC 28054-5523 | 2015-06-01 |
| 1679966600 | Sarah Yum | Counselor | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2015-03-16 |
| 1407255250 | Celia Noe | Marriage & Family Therapist | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2014-08-18 |
| 1124366075 | Jennifer Covington | Social Worker | 1552 Union Rd, Gastonia, NC 28054-5523 | 2013-01-28 |
| 1831406008 | Priscilla J Kifer | Counselor | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2010-09-08 |
| 1841517646 | Johnny Johnson Jr. | Social Worker | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2010-05-03 |
| 1023254810 | Robert Summey IIi | Counselor | 1552 Union Rd, Suite E, Gastonia, NC 28054-5523 | 2008-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861941049 | Impact Carolina Services Inc | Psychiatry & Neurology | 1006 Union Road, Suite B, Gastonia, NC 28054-0000 | 2016-09-28 |
| 1861833485 | John Anthony Brodston | Psychiatry & Neurology | 1391 E Garrison Blvd Ste C, Gastonia, NC 28054-5179 | 2013-07-11 |
| 1609118876 | Jiping Xiao | Psychiatry & Neurology | 1867 Remount Rd Ste H, Gastonia, NC 28054-7401 | 2013-03-26 |
| 1326161167 | David John Deas | Psychiatry & Neurology | 1006b Union Rd, Gastonia, NC 28054-5591 | 2007-04-09 |
| 1376660530 | Praful C Mehta | Psychiatry & Neurology | 1040 Xray Drive, Suite C, Gastonia, NC 28054 | 2007-03-23 |
| 1437265923 | Hope Psychiatric Pllc | Psychiatry & Neurology | 432 E Long Ave, Ste 1, Gastonia, NC 28053 | 2006-08-21 |
| 1477585677 | Subhash Pralad Patel | Psychiatry & Neurology | 438 E Long Ave Ste 1, Gastonia, NC 28054-3500 | 2006-07-07 |
| 1982691663 | Anoop Kumar Kalia | Psychiatry & Neurology | 1054 X Ray Dr, Gastonia, NC 28054-7488 | 2005-09-29 |
| 1508860230 | Donald Klasing | Psychiatry & Neurology | 1867 Remount Rd, Suite H, Gastonia, NC 28054-7401 | 2005-06-10 |
| 1053775189 | Vikram R. Shukla, Md Child, Adolescent & Adult Psychiatry Services | Psychiatry & Neurology | 839 Majestic Ct, Suite 8, Gastonia, NC 28054-5147 | 2016-04-05 |
| Find all providers in GASTONIA | ||||
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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.