Organization Active NPI

Impact Healthcare and Wellness

Doing business as Impact Mental Healthcare and Wellness

  • Case Management Agency
  • Houston, TX
National Provider Identifier
1073257325
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
IMPACT HEALTHCARE AND WELLNESS
Doing business as
Impact Mental Healthcare and Wellness
Practice address
7118 Champions Centre Estate Dr
Houston, TX 77069-2347
Phone
(832) 432-0303
NPI assigned
Apr 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Danielle S. Patton, LPC, NCCNPI 1679158950
Title
License Professional Counselor
Phone
(832) 432-0303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Case Management Agency 251B00000X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

7118 Champions Centre Estate Dr
Houston, TX 77069-2347

Mailing address

7118 Champions Centre Estate Dr
Houston, TX 77069-2347
Phone (832) 814-6167

Other identifiers 2

IdentifierTypeStateIssuer
87-8562783OtherTXBLUE CROSS BLUE SHIELD
878562783OtherTXAMERIGROUP

Other names 1

  • Impact Mental Healthcare and Wellness Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL SimplePractice Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250402000225 TX Part B Supplier - Clinic/Group Practice 6507389327 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

13910 Champion Forest Dr
Ste 111
Houston, TX 77069
Phone (832) 432-0301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1073257325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7118 CHAMPIONS CENTRE ESTATE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770692347",
            "telephone_number": "832-814-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7118 CHAMPIONS CENTRE ESTATE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770692347",
            "telephone_number": "832-432-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTHCARE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "LICENSE PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "832-432-0303",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "87-8562783",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "878562783",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7118 Champions Centre Estate Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770692347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Impact Mental Healthcare and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Impact Mental Healthcare and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.