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Impact Carolina Services,inc
Psychiatric/Mental Health Nurse Practitioner in Gastonia, North Carolina
NPI 1780135681

Impact Carolina Services,inc is a Psychiatric/Mental Health Nurse Practitioner based in Boger City, NC and is specialized in Psychiatric/Mental Health. Impact Carolina Services,inc practices in Gastonia, NC. The NPI Number for Impact Carolina Services,inc is 1780135681 and holds a License No. 795 (North Carolina).

The current practice location address for Impact Carolina Services,inc is 1006 Union Road, Gastonia, NC and can be reached out via phone at 704-864-8775 and via fax at 980-225-0549.

Location: 1006 Union Road, Gastonia, NC, 28092-0000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1780135681
Provider Name
Impact Carolina Services,inc
Credential
Provider Entity Type
Organization
Address
1006 Union Road, Gastonia, NC, 28092-0000
Phone Number
704-864-8775
Fax Number
980-225-0549
Provider Enumeration Date
10/17/2016
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5918094 05 NC
6008555 05 NC
institution
Provider Business Practice Location Address Details
Address
1006 Union Road
City
Gastonia
State
North Carolina
Zip
28054-0000
Phone Number
704-864-8775
Fax Number
980-225-0549
person
Provider Business Mailing Address Details
Address
1006 Union Road
City
Gastonia
State
North Carolina
Zip
28054-0000
Phone Number
704-864-8775
Fax Number
980-225-0549
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
NC1809906 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
CD07873 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Social Worker
Speciality
Clinical
Taxonomy
1041C0700X
License No.
C005215 (North Carolina)
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
person
Provider's Taxonomy Details 4
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
795 (North Carolina)
Definition
Definition to come...
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