| Impact Counseling, Llc | |
|
4640 Forbes Blvd Ste 120w Lanham MD 20706-6320 | |
| (301) 343-0463 | |
| Not Available |
| Full Name | Impact Counseling, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4640 Forbes Blvd Ste 120w, Lanham, Maryland |
| Authorized Official Name and Position | L R Dofat-avent (OWNER) |
| Authorized Official Contact | 3013430463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Counseling, Llc 10705 Vista Linda Dr Bowie MD 20721-4048 Ph: (301) 343-0463 | Impact Counseling, Llc 4640 Forbes Blvd Ste 120w Lanham MD 20706-6320 Ph: (301) 343-0463 |
| NPI Number | 1477192185 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477192185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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