IMPACT BEHAVIORAL COUNSELING LLC (NPI# 1912409764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912409764 |
| Entity Type | Organization |
| Organization Name | IMPACT BEHAVIORAL COUNSELING LLC |
| Practice Address |
1551 E County Line Rd Ste B Jackson MS 39211-1801 |
| Mailing Address |
37 Sandstone Cir Ste 110 Jackson TN 38305-2088 |
| Practice Telephone | 6019577343 |
| Practice Fax Number | 6019577344 |
| Mailing Telephone | 7312656025 |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-07 |
| Authorized Official Name | KRYSTAL L SPENCER (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 7312656025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235632696 | Impact Behavioral Counseling LLC | Counselor | 3600 Bluecutt Rd Ste 202, Columbus, MS 39705-1303 | 2018-03-13 |
| 1780187146 | Impact Behavioral Counseling LLC | Counselor | 48 Medical Park Dr E Ste 454, Birmingham, AL 35235-3400 | 2018-03-13 |
| 1609378546 | Impact Behavioral Counseling LLC | Counselor | 20 Hughes Rd Ste 101-b, Madison, AL 35758-2237 | 2018-03-07 |
| 1841792793 | Impact Behavioral Counseling LLC | Social Worker | 1 Medical Plaza Dr Ste B, Vicksburg, MS 39180-5187 | 2018-03-07 |
| 1942702899 | Impact Behavioral Counseling LLC | Social Worker | 2131 Military St S Ste 2, Hamilton, AL 35570-6651 | 2018-03-07 |
| 1295237048 | Impact Behavioral Counseling LLC | Counselor | 37 Sandstone Cir Ste 92b, Jackson, TN 38305-2089 | 2018-03-07 |
| 1992207740 | Impact Behavioral Counseling LLC | Social Worker | 22765 State Highway 59 S Ste B, Robertsdale, AL 36567-3197 | 2018-03-07 |
| 1386169050 | Impact Behavioral Counseling LLC | Counselor | 7515 Greenville Ave Ste 1060, Dallas, TX 75231-3810 | 2017-08-03 |
| 1871073916 | Impact Behavioral Counseling LLC | Counselor | 580 Providence Park Dr E Ste 124b, Mobile, AL 36695-4614 | 2018-08-17 |
| Street Address |
1551 E COUNTY LINE RD STE B |
| City | JACKSON |
| State | MS |
| Zip Code | 39211-1801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092878 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 5722 I-55 N Frontage Road, Jackson, MS 39211 | 2020-08-04 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1821628223 | Alice Powell Taylor | St. Dominic Weight Loss Solutions, 3800 Interstate 55 North Frontage Road Suite 102, Jackson, MS 39211 | 2020-01-24 | |
| 1356980643 | Bethany Powers | Pharmacist | 4910 Interstate 55 North Frontage Rd, Jackson, MS 39211 | 2020-01-03 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1285108357 | Eric Wood | Counselor | 4623 Maurey Rd, Jackson, MS 39211 | 2019-01-11 |
| 1649758301 | Isluv Robertson | Registered Nurse | 1405 E Northside Dr, Jackson, MS 39211 | 2018-08-03 |
| 1659863066 | Jonbrighton Childs Russell | Student in an Organized Health Care Education/Training Program | 4343 Dalrymple Ct, Jackson, MS 39211 | 2018-05-31 |
| 1225557598 | Regina Ann Day | Dietitian, Registered | 3800 I 55 North Frontage Road, Jackson, MS 39211 | 2017-09-18 |
| 1023558525 | Agilitas Usa Inc | Clinic/Center | 120 District Blvd E, Suite D102, Jackson, MS 39211 | 2017-03-02 |
| Find all providers in zip 39211 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952665 | John Cate Owen | Counselor | 2525 Lakeward Dr Ste 400, Jackson, MS 39216-4827 | 2020-11-04 |
| 1760098727 | Anna Marie Jones | Counselor | 32 Portsmouth St, Jackson, OH 45640-1622 | 2020-09-16 |
| 1891313656 | Kayla Lynn Fazzari | Counselor | N168w20964 Main St, Jackson, WI 53037-9634 | 2020-07-08 |
| 1184184202 | Tracy Dawn Schuh | Counselor | 300 Morton St, Jackson, OH 45640-1028 | 2019-03-24 |
| 1013483858 | Bradley A Tompson | Counselor | 794 Mcdonough Rd Ste 100, Jackson, GA 30233-1572 | 2018-10-19 |
| 1295237048 | Impact Behavioral Counseling LLC | Counselor | 37 Sandstone Cir Ste 92b, Jackson, TN 38305-2089 | 2018-03-07 |
| 1942708920 | Candace R Downey | Counselor | 120 Twin Oaks Dr Unit D, Jackson, OH 45640-9506 | 2018-01-25 |
| 1508379462 | Vicki Lee Harper | Counselor | 295 Broadway St Ste 101, Jackson, OH 45640-1701 | 2017-11-14 |
| 1356867295 | Stephanie Michelle Gilbert | Counselor | 345 E Main St Ste A, Jackson, OH 45640-1780 | 2017-08-22 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| Find all providers in JACKSON | ||||
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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.