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Organization

IMPACT COUNSELING CLINIC, INCORPORATED

Active
Parent organization
IMPACT COUNSELING CLINIC, INCORPORATED
Organization subpart
Yes

Provider details

NPI number
Legal business name
IMPACT COUNSELING CLINIC, INCORPORATED
Authorized official
PRISCILLA ANN FAULKNER LPC (CEO)
(870) 285-1413
Entity
Organization

Contact information

Practice address
408 N 1ST ST STE C, GLENWOOD, AR 71943-9252
(870) 356-7404
(870) 825-2060
Mailing address
PO BOX 416, DIERKS, AR 71833-0416
(870) 285-1413

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
09/08/2023
Last updated
09/08/2023
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