Healthcare Provider Details

I. General information

NPI: 1245853480
Provider Name (Legal Business Name): 2MPACT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 RICKEY BLVD UNIT 246
BEAR DE
19701-8610
US

IV. Provider business mailing address

125 RICKEY BLVD UNIT #246
BEAR DE
19701-8610
US

V. Phone/Fax

Practice location:
  • Phone: 302-397-1955
  • Fax: 302-861-0647
Mailing address:
  • Phone: 302-397-1955
  • Fax: 302-861-0647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALCHEMY GREEN
Title or Position: FOUNDER, CEO
Credential: LCSW-C, CAADC, SAP
Phone: 302-397-1955