Organization
IMPACT COUNSELING & SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TYSHICA RHODES LOFTON LCSW (CLINICAL DIRECTOR/CEO)
(505) 301-6330
Entity
Organization
Contact information
Practice address
1901 MANHATTAN BLVD BLDG D306, HARVEY, LA 70058-3582
(504) 250-1888
Mailing address
308 AUTUMN LAKES RD, SLIDELL, LA 70461-5106
(504) 301-6330
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/05/2018
Last updated
09/11/2023
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