Impact Counseling Services

LBN: Impact Lcsw Counseling Services, Pc
Impact Counseling Services is an health care organization with primary practice located at 2760 Middle Country Rd Suite 1, Lake Grove NY 11755-2113. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Impact Lcsw Counseling Services, Pc can be contacted via phone (631) 467-3181, or through Brunjes, Carol A via phone (631) 467-3181.

Contact Information

Primary practice address
2760 Middle Country Rd Suite 1 Lake Grove NY 11755-2113
Phone: (631) 467-3181
Fax: (631) 467-3185
Website:
Map and Directions
Authorized official contact:
Name: Brunjes, Carol A LCSW-R
Phone: (631) 467-3181

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R043837-1 New York

Profile Details

NPI number 1972522902
LBN Legal business name Impact Lcsw Counseling Services, Pc
DBA Doing business as Impact Counseling Services
Authorized official Brunjes, Carol A LCSW-R
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972522902 NPPES
New York Other 11569751 CAQH
New York MEDICAID 02756912 CAQH

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