| Impact Counseling Services | |
|
2760 Middle Country Rd Suite 1 Lake Grove NY 11755-2113 | |
| (631) 467-3181 | |
| (631) 467-3185 |
| Full Name | Impact Counseling Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2760 Middle Country Rd, Lake Grove, New York |
| Authorized Official Name and Position | Carol A Brunjes (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 6314673181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Counseling Services 2760 Middle Country Rd Suite 1 Lake Grove NY 11755-2113 Ph: (631) 467-3181 | Impact Counseling Services 2760 Middle Country Rd Suite 1 Lake Grove NY 11755-2113 Ph: (631) 467-3181 |
| NPI Number | 1972522902 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972522902 | NPI | - | NPPES |
| 11569751 | Other | NY | CAQH |
| 02756912 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R043837-1 (New York) | Primary |
Aspire Mental Health Counseling P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 Nesconset Hwy Ste 205, Lake Grove, NY 11755 Phone: 631-521-9603 Fax: 631-285-3660 | |
Impact Counseling Services I, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2760 Middle Country Rd, Suite 1, Lake Grove, NY 11755 Phone: 631-467-3182 Fax: 631-467-3178 | |
Dr. Donna Riley Office Of Licensed Clinical Social Work, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2233 Nesconset Hwy Ste 100, Lake Grove, NY 11755 Phone: 631-602-7856 Fax: 631-602-7857 |