Provider Demographics
NPI:1902680374
Name:IMPACT COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:IMPACT COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARKUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINGENSCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-373-0502
Mailing Address - Street 1:821 PRITCHARD ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-3580
Mailing Address - Country:US
Mailing Address - Phone:651-373-0502
Mailing Address - Fax:
Practice Address - Street 1:110 S APOPKA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4837
Practice Address - Country:US
Practice Address - Phone:352-560-7027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health