Organization
IMPACT COUNSELING AND CONSULTING LLC
Active
Organization
IMPACT COUNSELING AND CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA FAIRLINE RICKETTS (LMHC)
(352) 587-2378
Entity
Organization
Contact information
Practice address
6563 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6003
(727) 390-9181
Mailing address
PO BOX 2581, INVERNESS, FL 34451-2581
(352) 419-4856
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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