MEDICARE: IMPACT ABA SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	LBA00109	NV

General Provider Information

NPI Number	:	1164949590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPACT ABA SERVICES, LLC

Provider Business Mailing Address
First Line	:	2395 LINCOLN MEADOWS DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89521-5252
Country	:	US
Telephone Number	:	775-376-9426
Fax Number	:	775-376-5888

Provider Business Practice Location Address
First Line	:	5345 RENO CORPORATE DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-2381
Country	:	US
Telephone Number	:	775-376-9426
Fax Number	:

Authorized Official
Title or Position	:	CEO/BCBA
Name	:	DR. MEGAN M MCGREW
Credential	:	PHD, BCBA, LBA
Telephone Number	:	775-376-9426

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	05/29/2026

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