Impact Therapy Llc | |
627 Noric Cv Union City GA 30291-3456 | |
(404) 662-0504 | |
Not Available |
Full Name | Impact Therapy Llc |
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Speciality | Counselor |
Location | 627 Noric Cv, Union City, Georgia |
Authorized Official Name and Position | Turnmeika Smith (CEO) |
Authorized Official Contact | 4046620504 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Impact Therapy Llc 627 Noric Cv Union City GA 30291-3456 Ph: () - | Impact Therapy Llc 627 Noric Cv Union City GA 30291-3456 Ph: (404) 662-0504 |
NPI Number | 1881332922 |
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Provider Enumeration Date | 05/26/2022 |
Last Update Date | 10/03/2023 |
Certification Date | 10/03/2023 |
Medicare PECOS PAC ID | 4880037357 |
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Medicare Enrollment ID | O20240212003414 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881332922 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Turnmeika Smith |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1659019792 PECOS PAC ID: 5799128260 Enrollment ID: I20240212003459 |
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