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IMPACT CAROLINA SERVICES INC NPI 1619285756


NPI Information

NPI: 1619285756
Provider Name: IMPACT CAROLINA SERVICES, INC
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
2848 QUEEN CITY DR STE G
CHARLOTTE, NC
ZIP 28208
Phone: (704) 405-1617
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IMPACT CAROLINA SERVICES, INC is a psychiatry psychiatry neurology in Charlotte, NC. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. IMPACT CAROLINA SERVICES, INC NPI is 1619285756. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2848 QUEEN CITY DR STE G
CHARLOTTE, NC
ZIP 28208-739
Phone: (704) 405-1617
Fax: (704) 405-1619

The provider's authorized official is Joseph Adedokun .
The authorized official title is Director/ceo and has the following contact phone number (704) 405-1617.

The enumeration date for this NPI number is 9/23/2010 and was last updated on 9/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)795NORTH CAROLINANo
2101YP2500XCounselorProfessional5171NORTH CAROLINANo
31041C0700XSocial WorkerClinicalC001664NORTH CAROLINANo
4363LA2200XNurse PractitionerAdult Health0600071NORTH CAROLINANo
52084P0800XPsychiatry & NeurologyPsychiatryNC 2005-00391NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16006650MEDICAIDNORTH CAROLINA
22347954MEDICARE PINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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