| Impact Behavioral Counseling Llc | |
|
7515 Greenville Ave Ste 1060 Dallas TX 75231-3810 | |
| (866) 407-4929 | |
| Not Available |
| Full Name | Impact Behavioral Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 7515 Greenville Ave Ste 1060, Dallas, Texas |
| Authorized Official Name and Position | Andrew Turner (PRESIDENT/COO) |
| Authorized Official Contact | 2052089312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Behavioral Counseling Llc 1000 Urban Center Dr Ste 600 Vestavia AL 35242-2584 Ph: (205) 208-9312 | Impact Behavioral Counseling Llc 7515 Greenville Ave Ste 1060 Dallas TX 75231-3810 Ph: (866) 407-4929 |
| NPI Number | 1386169050 |
|---|---|
| Provider Enumeration Date | 08/03/2017 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/02/2025 |
| Medicare PECOS PAC ID | 1355604836 |
|---|---|
| Medicare Enrollment ID | O20180416000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386169050 | NPI | - | NPPES |
| Provider Name | Deborah Gross |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982717997 PECOS PAC ID: 2769438480 Enrollment ID: I20050325000324 |
| Provider Name | Porter Mckee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659797819 PECOS PAC ID: 9537422035 Enrollment ID: I20180416001858 |
| Provider Name | Stuart Milan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689766958 PECOS PAC ID: 6305189788 Enrollment ID: I20190529000481 |
| Provider Name | Garic Grisbaum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902217581 PECOS PAC ID: 6002223252 Enrollment ID: I20210406000398 |
| Provider Name | Raven M Campbell-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235544339 PECOS PAC ID: 5193946671 Enrollment ID: I20211124000740 |
| Provider Name | Leon K Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982828158 PECOS PAC ID: 9638501950 Enrollment ID: I20220516002789 |
| Provider Name | Allan Rowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386098499 PECOS PAC ID: 9234505496 Enrollment ID: I20221013001689 |
| Provider Name | Edith Royal Cheney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235609744 PECOS PAC ID: 2163836248 Enrollment ID: I20230420000571 |
| Provider Name | Blake Towe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992170492 PECOS PAC ID: 3476941253 Enrollment ID: I20230929000642 |
| Provider Name | Melissa Ratliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841488517 PECOS PAC ID: 4981057148 Enrollment ID: I20240124003333 |
| Provider Name | Amanda Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538419932 PECOS PAC ID: 1355889643 Enrollment ID: I20240819000222 |
| Provider Name | Christian Brooks Shearer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841973716 PECOS PAC ID: 6901258821 Enrollment ID: I20241212003652 |
| Provider Name | Fulivia Elma Cannady |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306085253 PECOS PAC ID: 6406385491 Enrollment ID: I20250121000691 |
| Provider Name | Nakeesha Longmire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881054625 PECOS PAC ID: 2264861749 Enrollment ID: I20250224003222 |
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