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IMPACT CAROLINA SERVICES NPI 1629311063


NPI Information

NPI: 1629311063
Provider Name: IMPACT CAROLINA SERVICES
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
1552 UNION RD
SUITE C
GASTONIA, NC
ZIP 28054
Phone: (704) 852-9210
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IMPACT CAROLINA SERVICES is a psychiatry psychiatry neurology in Gastonia, 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 NPI is 1629311063. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1552 UNION RD
SUITE C
GASTONIA, NC
ZIP 28054-523
Phone: (704) 852-9210
Fax: (704) 852-9211

The provider's authorized official is Joseph Adedokun .
The authorized official title is Ceo and has the following contact phone number (704) 732-2006.

The enumeration date for this NPI number is 4/4/2013 and was last updated on 4/4/2013.


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
1101YA0400XCounselorAddiction (Substance Use Disorder)795NORTH CAROLINANo
21041C0700XSocial WorkerClinicalC002728NORTH CAROLINANo
3363L00000XNurse Practitioner5004878NORTH CAROLINANo
4363LA2200XNurse PractitionerAdult Health5004910NORTH CAROLINANo
52084P0800XPsychiatry & NeurologyPsychiatryNC 93-00472NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12347954MEDICARE UPINNORTH CAROLINA
25004910MEDICAIDNORTH CAROLINA
36003129MEDICAIDNORTH CAROLINA
42339728MEDICARE UPINNORTH CAROLINA
56111767MEDICAIDNORTH CAROLINA
6891036YMEDICAIDNORTH CAROLINA
72194712FMEDICARE UPINNORTH CAROLINA
85004878MEDICAIDNORTH 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: 5/5/2024

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