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General NPI Number Information
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NPI Number | 1073257325
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Entity Type | Organization
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Legal Business Name | IMPACT HEALTHCARE AND WELLNESS
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 7118 CHAMPIONS CENTRE ESTATE DR
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City | HOUSTON
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State | TX
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Zip | 77069-2347
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Country | US
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Telephone | 832-432-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 7118 CHAMPIONS CENTRE ESTATE DR
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City | HOUSTON
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State | TX
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Zip | 77069-2347
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Country | US
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Telephone | 832-814-6167
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Fax |
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Authorized Official
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Title or Position | LICENSE PROFESSIONAL COUNSELOR
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Name | MRS. DANIELLE S. PATTON
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Credential | LPC, NCC
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Telephone | 832-432-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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