COURAGEOUS IMPACT ADVOCACY & SUPPORT NPI 1649141755

NPI Information

  • NPI: 1649141755
  • Provider Name: COURAGEOUS IMPACT ADVOCACY & SUPPORT
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Organization
  • Address: 2179 BAYSIDE DR SW
    SUPPLY, NC
    ZIP 28462
  • Phone: (910) 918-5586

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NPI Details

COURAGEOUS IMPACT ADVOCACY & SUPPORT is a peer specialist in Supply, NC. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. COURAGEOUS IMPACT ADVOCACY & SUPPORT NPI is 1649141755. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2179 BAYSIDE DR SW
SUPPLY, NC
ZIP 28462-977
Phone: (910) 918-5586

The provider's authorized official is Nyisha Powell .
The authorized official title is Cfps, Ceo and has the following contact phone number (910) 918-5586.

The enumeration date for this NPI number is 9/13/2025 and was last updated on 9/13/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior AnalystNo
2106S00000XBehavior TechnicianNo
3251S00000XCommunity/Behavioral HealthNo
4175T00000XPeer SpecialistYes

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: 11/21/2025

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