| Impact Counseling And Consulting Llc | |
|
110 S Apopka Ave Inverness FL 34452-4837 | |
| (362) 560-7027 | |
| Not Available |
| Full Name | Impact Counseling And Consulting Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 110 S Apopka Ave, Inverness, Florida |
| Authorized Official Name and Position | Myra Fairline Ricketts (OWNER) |
| Authorized Official Contact | 3525872378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Counseling And Consulting Llc 110 S Apopka Ave Inverness FL 34452-4837 Ph: () - | Impact Counseling And Consulting Llc 110 S Apopka Ave Inverness FL 34452-4837 Ph: (362) 560-7027 |
| NPI Number | 1487320883 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 0042617730 |
|---|---|
| Medicare Enrollment ID | O20210922003409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487320883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dianne M Giammarco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871633115 PECOS PAC ID: 5092959411 Enrollment ID: I20130924000773 |
| Provider Name | Dianne E Doane-bustetter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790218501 PECOS PAC ID: 6204105976 Enrollment ID: I20170712001265 |
| Provider Name | Hysintine Palle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609368414 PECOS PAC ID: 5698174274 Enrollment ID: I20210602001265 |
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