Organization
IMPACT COUNSELING SERVICES I, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL ANN BRUNJES LCSW R (CEO CLINICAL DIRECTOR)
(631) 467-3182
Entity
Organization
Contact information
Practice address
2760 MIDDLE COUNTRY RD, SUITE 1, LAKE GROVE, NY 11755-2113
(631) 467-3182
(631) 467-3178
Mailing address
2760 MIDDLE COUNTRY RD, SUITE 1, LAKE GROVE, NY 11755-2113
(631) 467-3182
(631) 467-3178
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
080411616
NY
Other
Enumeration date
05/03/2007
Last updated
04/22/2015
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