| Impact Therapy Llc | |
|
627 Noric Cv Union City GA 30291-3456 | |
| (404) 662-0504 | |
| Not Available |
| Full Name | Impact Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 627 Noric Cv, Union City, Georgia |
| Authorized Official Name and Position | Turnmeika Smith (CEO) |
| Authorized Official Contact | 4046620504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Therapy Llc 627 Noric Cv Union City GA 30291-3456 Ph: () - | Impact Therapy Llc 627 Noric Cv Union City GA 30291-3456 Ph: (404) 662-0504 |
| NPI Number | 1881332922 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 10/03/2023 |
| Certification Date | 10/03/2023 |
| Medicare PECOS PAC ID | 4880037357 |
|---|---|
| Medicare Enrollment ID | O20240212003414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881332922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Turnmeika Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659019792 PECOS PAC ID: 5799128260 Enrollment ID: I20240212003459 |
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