IMPACT WELLNESS CENTER LLC
NPI 1205509205
Counselor - Mental Health in North Chesterfield, VA
Active since July 27, 2021
About Impact Wellness Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IMPACT WELLNESS CENTER LLC (NPI 1205509205) is a healthcare organization registered as a mental health in North Chesterfield, Virginia and active in the NPI registry since July 2021. The organization lists Phillip C Stafford, Ceo, as its authorized official.
NPPES Registry Identity
NPI1205509205
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameIMPACT WELLNESS CENTER LLC
Location Address2700 GALENA AVENorth Chesterfield, VA 23237-4638
Mailing Address2700 Galena AveNorth Chesterfield, VA 23237-4638 · (702) 754-9136
Phone(702) 754-9136
Organization SubpartNo
Authorized OfficialPhillip C StaffordCeo · (702) 754-9063
Enumeration DateJuly 27, 2021
NPPES CertifiedJuly 27, 2021
✔ NPI 1205509205 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 4
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X
Also ListedPsychologist · CounselingTaxonomy 103TC1900X
Also ListedPsychologist · Intellectual and Developmental DisabilitiesTaxonomy 103TM1800X
2700 GALENA AVE, North Chesterfield, VA 23237
Group Practice 1
Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205509205, enumerated as an "organization" on July 27, 2021.
The provider is located at 2700 GALENA AVE NORTH CHESTERFIELD, VA 23237 and the phone number is (702) 754-9136.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
