Impact Counseling Clinic, Incorporated

NPI #1205388071 in Dierks, Arkansas

Provider Information

NPI Number: 1205388071
Entity Type: Organization
Organization Name: Impact Counseling Clinic, Incorporated
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: Oct 27, 2016
Last Updated: Aug 20, 2021

Practice Location

Address: 1124 MAIN AVE
City: Dierks
State: Arkansas
ZIP Code: 71833-9421
Phone: (870) 285-1413

Authorized Official

Name: MRS. PRISCILLA ANN FAULKNER, LPC
Title: CEO
Phone: (870) 285-1413

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X	Primary

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