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IMPACT COUNSELING CLINIC, INCORPORATED
NPI 1205388071
Clinic/Center - Adolescent and Children Mental Health in Dierks, AR

Active since October 27, 2016
1124 MAIN AVE, DIERKS, AR 71833(870) 285-1413(870) 825-2060 Get Directions Write a Review

NPPES record last updated: August 20, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 20, 2021, Oct 27, 2016 (2 updates tracked since 2016).

About Impact Counseling Clinic, Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPACT COUNSELING CLINIC, INCORPORATED (NPI 1205388071) is a healthcare organization registered as an adolescent and children mental health in Dierks, Arkansas and active in the NPI registry since October 2016. The organization maintains a secondary practice location in Dierks and lists Priscilla Ann Faulkner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205388071
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameIMPACT COUNSELING CLINIC, INCORPORATED
Location Address1124 MAIN AVEDierks, AR 71833-9421
Mailing AddressPo Box 575Dierks, AR 71833-0575 · (870) 285-1413 · Fax (870) 825-2060
Phone(870) 285-1413
Fax(870) 825-2060
Organization SubpartNo
Authorized OfficialPriscilla Ann FaulknerCeo · (870) 285-1413
Enumeration DateOctober 27, 2016
Last NPPES UpdateAugust 20, 20212 updates tracked since enumeration
NPPES CertifiedAugust 20, 2021
✔ NPI 1205388071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
1124 MAIN AVE, Dierks, AR 71833
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Secondary Practice Location 1

Location 11123 Main AvenueDierks, AR 71833 · Phone (870) 285-1413

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VERONICA OZURA LAC
Counselor (Mental Health)
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 584-9568
KELSI DAWN BROWN
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 784-0884
JUSTIN BEAN
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 784-0884
BREANNA NICOLE MOUNTS
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 784-0884
PRISCILLA ANN FAULKNER LPC
Counselor (Mental Health)
1124 MAIN AVE
DIERKS, AR 71833
Howard County (187) 028-5141
KATLYN STRAWN
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 784-0884
TERESA RAMIREZ
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 925-1572
HANNAH NICOLE ELLIS
Case Manager/Care Coordinator
1124 MAIN AVE
DIERKS, AR 71833
Howard County (870) 784-0884

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impact Counseling Clinic, Incorporated's NPI number?

The NPI number for Impact Counseling Clinic, Incorporated is 1205388071. It was assigned to this organization in the NPPES registry on October 27, 2016.

Where is Impact Counseling Clinic, Incorporated located?

Impact Counseling Clinic, Incorporated is located at 1124 Main Ave, Dierks, AR 71833. The listed phone number is (870) 285-1413.

What is Impact Counseling Clinic, Incorporated's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

What insurance does Impact Counseling Clinic, Incorporated accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Impact Counseling Clinic, Incorporated as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Impact Counseling Clinic, Incorporated was last updated on August 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.