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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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