| Impact Counseling And Consulting Llc | |
|
582 Se 7th Ave Ste B Crystal River FL 34429-4840 | |
| (352) 228-8829 | |
| Not Available |
| Full Name | Impact Counseling And Consulting Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 582 Se 7th Ave Ste B, Crystal River, Florida |
| Authorized Official Name and Position | Myra Fairline Ricketts (DIRECTOR) |
| Authorized Official Contact | 3525872378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Counseling And Consulting Llc 582 Se 7th Ave Ste B Crystal River FL 34429-4840 Ph: (352) 228-8829 | Impact Counseling And Consulting Llc 582 Se 7th Ave Ste B Crystal River FL 34429-4840 Ph: (352) 228-8829 |
| NPI Number | 1336858711 |
|---|---|
| Provider Enumeration Date | 11/15/2022 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336858711 | NPI | - | NPPES |
| 101703300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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