NPIMap

Organization Active NPI

Major Impact, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Fort Myers, FL
National Provider Identifier
1407211535
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2036AD2405-01 Issued in FL
Legal business name
MAJOR IMPACT, INC.
Doing business as
Major Impact, Inc.
Practice address
1960 Velasco St
Suite J-2
Fort Myers, FL 33916-2761
Phone
(239) 226-4357
Fax
(239) 226-4352
NPI assigned
Dec 16, 2015
Last updated
Dec 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Authorized official

Name
Mr. Clayton Lambert Major Sr., M.S.NPI 1609005883
Title
Co-Owner
Phone
(239) 226-4357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 2036AD2405-01 FL Primary

Addresses

Primary practice location

1960 Velasco St
Suite J-2
Fort Myers, FL 33916-2761

Mailing address

1960 Velasco St
Suite J-2
Fort Myers, FL 33916-2761
Phone (239) 226-4357

Other names 1

  • Major Impact, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Major Impact Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1407211535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 VELASCO ST",
            "address_2": "SUITE J-2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162761",
            "telephone_number": "239-226-4357",
            "fax_number": "239-226-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 VELASCO ST",
            "address_2": "SUITE J-2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162761",
            "telephone_number": "239-226-4357",
            "fax_number": "239-226-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJOR IMPACT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "MAJOR",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "LAMBERT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "239-226-4357",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "2036AD2405-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Major Impact, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.