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General NPI Number Information
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NPI Number | 1851749220
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Entity Type | Organization
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Legal Business Name | IMPACT COUNSELING AND WELLNESS, LLC
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 3531 DE SOTO ST
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City | HOUSTON
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State | TX
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Zip | 77091-3719
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Country | US
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Telephone | 713-294-2439
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Fax |
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Provider Business Mailing Address
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Address Line | 3531 DE SOTO ST
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City | HOUSTON
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State | TX
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Zip | 77091-3719
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Country | US
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Telephone | 713-294-2439
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. HOLLY LEE-MCCAIN
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Credential | LPC-S
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Telephone | 713-294-2439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17269
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License Number State | TX
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