IMPACT CAROLINA SERVICES,INC (NPI# 1780135681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780135681 |
| Entity Type | Organization |
| Organization Name | IMPACT CAROLINA SERVICES,INC |
| Practice Address |
1006 Union Road Suite B Gastonia NC 28054-0000 |
| Mailing Address |
106 Doctors Park Suite B Boger City NC 28092-0000 |
| Practice Telephone | 7048648775 |
| Practice Fax Number | 9802250549 |
| Mailing Telephone | 7047322006 |
| Mailing Fax Number | 7047320303 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | DR. JOSEPH ADEDOKUN (DIRECTOR) |
| Authorized Official Telephone | 7047322006 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
795 | NC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CD07873 | NC | Behavioral Health & Social Service Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
NC1809906 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
C005215 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5918094 | 05 | |
| NC | 6008555 | 05 |
| Street Address |
1006 UNION ROAD SUITE B |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861941049 | Impact Carolina Services Inc | Psychiatry & Neurology | 1006 Union Road, Suite B, Gastonia, NC 28054-0000 | 2016-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958779 | Family Means Everything Inc | Counselor | 2713 Crescent Ln, Gastonia, NC 28052-1120 | 2020-10-08 |
| 1932720034 | Carolina Behavioral Health Solutions | Counselor | 1006 Union Rd Ste E, Gastonia, NC 28054-5591 | 2020-04-29 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1952848319 | Alison Abbott | Counselor | 2571a Pembroke Rd, Gastonia, NC 28054-4712 | 2017-01-24 |
| 1972052579 | Julia H Oesterle | Counselor | 5563 Weavers Row, Gastonia, NC 28056-8586 | 2016-09-25 |
| 1952754566 | Carenet, Inc. | Counselor | 1621 E Garrison Blvd, Gastonia, NC 28054-5130 | 2016-07-19 |
| 1487028098 | Stefanie Mann | Counselor | 165 West Franklin Blvd., Gastonia, NC 28052 | 2015-11-19 |
| 1952772006 | Rebecca Escalante | Counselor | 1800 Yellowstone Ct, Apt J, Gastonia, NC 28054-1737 | 2015-10-15 |
| 1467829127 | Pinnacle Family Services of North Carolina LLC | Counselor | 330 S York St, Gastonia, NC 28052-4052 | 2015-08-28 |
| 1588030738 | Fullscope Counseling Services | Counselor | 1554c Union Rd Ste 2, Gastonia, NC 28054-5541 | 2015-08-11 |
| Find all providers in GASTONIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.