Organization
COURAGEOUS IMPACT ADVOCACY & SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NYISHA POWELL CFPS (CFPS, CEO)
(910) 918-5586
Entity
Organization
Contact information
Practice address
2179 BAYSIDE DR SW, SUPPLY, NC 28462-3977
(910) 918-5586
Mailing address
2179 BAYSIDE DR SW, SUPPLY, NC 28462-3977
(910) 918-5586
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/13/2025
Last updated
09/13/2025
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