IMPACT CAROLINA SERVICES INC (NPI# 1861941049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861941049 |
Entity Type | Organization |
Organization Name | IMPACT CAROLINA SERVICES INC |
Practice Address |
1006 Union Road Suite B Gastonia NC 28054-0000 |
Practice Telephone | 7048648775 |
Practice Fax Number | 9802250549 |
Mailing Telephone | 7048648775 |
Mailing Fax Number | 9802250549 |
Enumeration Date | 2016-09-28 |
Last Update Date | 2016-09-28 |
Authorized Official Name | DR. JOSEPH O ADEDOKUN (DIRECTOR) |
Authorized Official Telephone | 7047322006 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
NC | Allopathic & Osteopathic Physicians | |
N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NC | Physician Assistants & Advanced Practice Nursing Providers | |
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
NC | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 6006650 | 05 |
Street Address |
1006 UNION ROAD SUITE B |
City | GASTONIA |
State | NC |
Zip Code | 28054-0000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780135681 | Impact Carolina Services,inc | Counselor | 1006 Union Road, Suite B, Gastonia, NC 28054-0000 | 2016-10-17 |
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 | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578172615 | Heather Riggs | Counselor | 1931 E Hudson Blvd Apt F, Gastonia, NC 28054-1617 | 2020-07-24 |
1447895156 | Courtney Pack | Counselor | 359 W Main Ave Ste F, Gastonia, NC 28052-4509 | 2019-11-18 |
1447734181 | Blossom Community Services | Counselor | 1911 Willimax Ave, Gastonia, NC 28054-7440 | 2018-09-19 |
1164930293 | Dianne Huitt | Counselor | 176 W Franklin Blvd, Gastonia, NC 28052-4107 | 2018-01-10 |
1811388911 | Amanda Michelle Collman-murphy | Counselor | 1132 E Franklin Blvd, Gastonia, NC 28054-4244 | 2015-02-10 |
1740694785 | Grace Muretta Perkins | Counselor | 2020 Remount Rd Ste 105e, Gastonia, NC 28054-7478 | 2014-06-18 |
1437581279 | Letha Lucinda Stroman | Counselor | 418 S South St, Gastonia, NC 28052-4380 | 2013-08-03 |
1528408002 | Carolina Maria Abello | Counselor | 150 Buena Vale Dr, Gastonia, NC 28056-8509 | 2013-06-28 |
1770821639 | Deidre Shawn Williams | Counselor | 2224 Hudson Landings Dr Apt H, Gastonia, NC 28054-0735 | 2013-01-27 |
1346591161 | Joey Douglas Lockman | Counselor | 325 N Marietta St, Gastonia, NC 28052-2331 | 2012-09-20 |
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.