Impact Behavioral Counseling Llc | |
7515 Greenville Ave Ste 1060 Dallas TX 75231-3810 | |
(866) 407-4929 | |
Not Available |
Full Name | Impact Behavioral Counseling Llc |
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Speciality | Counselor |
Location | 7515 Greenville Ave Ste 1060, Dallas, Texas |
Authorized Official Name and Position | Andrew Turner (PRESIDENT/COO) |
Authorized Official Contact | 2052089312 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Impact Behavioral Counseling Llc 1000 Urban Center Dr Ste 600 Vestavia AL 35242-2584 Ph: (205) 208-9312 | Impact Behavioral Counseling Llc 7515 Greenville Ave Ste 1060 Dallas TX 75231-3810 Ph: (866) 407-4929 |
NPI Number | 1386169050 |
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Provider Enumeration Date | 08/03/2017 |
Last Update Date | 06/29/2023 |
Certification Date | 06/29/2023 |
Medicare PECOS PAC ID | 1355604836 |
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Medicare Enrollment ID | O20180416000807 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386169050 | NPI | - | NPPES |
Provider Name | Deborah Gross |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1982717997 PECOS PAC ID: 2769438480 Enrollment ID: I20050325000324 |
Provider Name | Porter Mckee |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659797819 PECOS PAC ID: 9537422035 Enrollment ID: I20180416001858 |
Provider Name | Stuart Milan |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689766958 PECOS PAC ID: 6305189788 Enrollment ID: I20190529000481 |
Provider Name | Garic Grisbaum |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1902217581 PECOS PAC ID: 6002223252 Enrollment ID: I20210406000398 |
Provider Name | Jessica Hobold |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952973695 PECOS PAC ID: 5799188744 Enrollment ID: I20210728001510 |
Provider Name | Leon K Edwards |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1982828158 PECOS PAC ID: 9638501950 Enrollment ID: I20220516002789 |
Provider Name | Allan Rowe |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1386098499 PECOS PAC ID: 9234505496 Enrollment ID: I20221013001689 |
Provider Name | Edith Royal Cheney |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1235609744 PECOS PAC ID: 2163836248 Enrollment ID: I20230420000571 |
Provider Name | Blake Towe |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992170492 PECOS PAC ID: 3476941253 Enrollment ID: I20230929000642 |
Provider Name | Christian Brooks Shearer |
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Provider Type | Practitioner - Other (non-physician) |
Provider Identifiers | NPI Number: 1841973716 PECOS PAC ID: 6901258821 Enrollment ID: I20240116004499 |
Provider Name | Melissa Ratliff |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1841488517 PECOS PAC ID: 4981057148 Enrollment ID: I20240124003333 |
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