| Impact Counseling And Consulting Llc | |
|
3404 N Lecanto Hwy Ste D Beverly Hills FL 34465-3569 | |
| (352) 587-2378 | |
| Not Available |
| Full Name | Impact Counseling And Consulting Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3404 N Lecanto Hwy Ste D, Beverly Hills, Florida |
| Authorized Official Name and Position | Myra Fairline Ricketts (OWNER) |
| 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 Po Box 2581 Inverness FL 34451-2581 Ph: () - | Impact Counseling And Consulting Llc 3404 N Lecanto Hwy Ste D Beverly Hills FL 34465-3569 Ph: (352) 587-2378 |
| NPI Number | 1417443094 |
|---|---|
| Provider Enumeration Date | 07/06/2018 |
| Last Update Date | 03/17/2023 |
| Certification Date | 03/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417443094 | NPI | - | NPPES |
| 1017033-00 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH16109 (Florida) | Secondary |
| 251S00000X | Community/behavioral Health | MH16109 (Florida) | Primary |
Impact Counseling And Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3404 N Lecanto Hwy Ste D, Beverly Hills, FL 34465 Phone: 352-419-4856 | |
Citrus County Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4882 W Phoenix Dr, Beverly Hills, FL 34465 Phone: 352-423-3163 |