IMPACT LCSW COUNSELING SERVICES PC NPI 1972522902

NPI Information

  • NPI: 1972522902
  • Provider Name: IMPACT LCSW COUNSELING SERVICES, PC
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Doing Business As: IMPACT COUNSELING SERVICES
  • Address: 2760 MIDDLE COUNTRY RD
    SUITE 1
    LAKE GROVE, NY
    ZIP 11755
  • Phone: (631) 467-3181

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NPI Details

IMPACT LCSW COUNSELING SERVICES, PC is a clinical social worker in Lake Grove, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. IMPACT LCSW COUNSELING SERVICES, PC NPI is 1972522902. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Impact Counseling Services.

The provider's business location address is:

2760 MIDDLE COUNTRY RD
SUITE 1
LAKE GROVE, NY
ZIP 11755-113
Phone: (631) 467-3181
Fax: (631) 467-3185

The provider's authorized official is Carol A Brunjes .
The authorized official title is Ceo/clinical Director and has the following contact phone number (631) 467-3181.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 8/22/2020.

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
11041C0700XSocial WorkerClinicalR043837-1NEW YORKYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
111569751OTHERNEW YORKCAQH
202756912MEDICAIDNEW YORK

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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