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IMPACT COUNSELING CONSULTING LLC
NPI 1366151730
Community/Behavioral Health in Pueblo, CO

Active since November 15, 2022

NPPES record last updated: November 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Impact Counseling Consulting Llc NPPES

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

IMPACT COUNSELING CONSULTING LLC (NPI 1366151730) is a healthcare organization registered as a community/behavioral health in Pueblo, Colorado and active in the NPI registry since November 2022. The organization maintains a secondary practice location in Crystal River and lists Myra Fairline Ricketts, Director, as its authorized official.

NPPES Registry Identity

NPI1366151730
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameIMPACT COUNSELING CONSULTING LLC
Location Address4 AVIS AVEPueblo, CO 81005-3102
Mailing Address4 Avis AvePueblo, CO 81005-3102 · (719) 256-1327
Phone(719) 256-1327
Organization SubpartNo
Authorized OfficialMyra Fairline RickettsDirector · (352) 587-2378
Enumeration DateNovember 15, 2022
NPPES CertifiedNovember 15, 2022
✔ NPI 1366151730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4 AVIS AVE, Pueblo, CO 81005
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Secondary Practice Location 1

Location 1582 SE 7th Ave Ste BCrystal River, FL 34429-4840 · Phone (352) 228-8829

Other Identifiers 1

Medicaid9000202666CO

Other Providers at the Same Location NPPES 4

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

HEATHER WILLIAMS
Counselor
4 AVIS AVE
PUEBLO, CO 81005
Pueblo County (719) 256-0127
GINA MARIE RAIGOZA MBA
Counselor
4 AVIS AVE
PUEBLO, CO 81005
Pueblo County (719) 256-0127
SAMUEL ADAM GALLEGOS
Counselor
4 AVIS AVE
PUEBLO, CO 81005
Pueblo County (719) 256-0127
KALYN FAHLSTEDT
Registered Nurse
4 AVIS AVE
PUEBLO, CO 81005
Pueblo County (970) 999-4714

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 Consulting LLC's NPI number?

The NPI number for Impact Counseling Consulting LLC is 1366151730. It was assigned to this organization in the NPPES registry on November 15, 2022.

Where is Impact Counseling Consulting LLC located?

Impact Counseling Consulting LLC is located at 4 Avis Ave, Pueblo, CO 81005. The listed phone number is (719) 256-1327.

What is Impact Counseling Consulting LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Impact Counseling Consulting LLC was last updated on November 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.