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MAJOR IMPACT INC. NPI 1407211535


NPI Information

NPI: 1407211535
Provider Name: MAJOR IMPACT, INC.

Doing Business As: MAJOR IMPACT, INC.

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
1960 VELASCO ST
SUITE J-2
FORT MYERS, FL
ZIP 33916
Phone: (239) 226-4357
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MAJOR IMPACT, INC. is an addiction (substance use disorder) counselor in Fort Myers, FL. MAJOR IMPACT, INC. NPI is 1407211535. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Major Impact, Inc..

The provider's business location address is:

1960 VELASCO ST
SUITE J-2
FORT MYERS, FL
ZIP 33916-761
Phone: (239) 226-4357
Fax: (239) 226-4352

The provider's authorized official is Clayton Lambert Major .
The authorized official title is Co-owner and has the following contact phone number (239) 226-4357.

The enumeration date for this NPI number is 12/16/2015 and was last updated on 12/16/2015.


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)2036AD2405-01FLORIDAYes

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
1003799000MEDICAIDFLORIDA

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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