Impact

Counselor · Port Huron, MI

Organization Active NPI

NPI number 1407130578

Practice location

1001 Military St
Port Huron, MI 48060-5416
Phone
(810) 985-5168
Fax
(800) 248-1568

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NPI record

NPI
1407130578
Entity type
Organization (Type 2)
Enumeration date
October 6, 2011
Last updated
October 6, 2011
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Counselor Primary 101Y00000X 6801093360 MI

Authorized official

Name
Mr. Robert E. Gamble, PH.D
Title
Clinical Director
Phone
(810) 985-5168

Other names

  • CHR

About Impact

Impact is a healthcare organization registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 1001 Military St, Port Huron, MI 48060-5416. The NPI number 1407130578 was assigned on October 6, 2011 and the record was last updated on October 6, 2011.

Impact lists a license in the registry: #6801093360 (MI) for Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mr. Robert E. Gamble, PH.D, Clinical Director.

Frequently asked questions

What is the NPI number of Impact?

The NPI number is 1407130578.

What is the phone number of Impact?

The phone number listed for the practice location is (810) 985-5168.

Where is Impact located?

1001 Military St, Port Huron, MI 48060-5416.

What is the taxonomy code for Impact?

The primary taxonomy code is 101Y00000X – Counselor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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