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General NPI Number Information
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NPI Number | 1639760259
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Entity Type | Organization
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Legal Business Name | IMPACT HEALTH & WELLNESS
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 100 CAMPUS TOWN CIR STE 103
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City | EWING
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State | NJ
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Zip | 08638-1962
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Country | US
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Telephone | 973-953-9780
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Fax |
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Provider Business Mailing Address
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Address Line | 350 S BROAD ST APT 305
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City | TRENTON
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State | NJ
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Zip | 08608-2525
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Country | US
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Telephone | 862-333-8230
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Fax |
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Authorized Official
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Title or Position | SCHOOL PSYCHOLOGIST
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Name | DANIELLE NARKAUS
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Credential | PSYD
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Telephone | 862-333-8230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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