Impact Counseling and Treatment Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

IMPACT COUNSELING AND TREATMENT SERVICES, LLC

Practice address

6003 W Overland Rd Ste 101
Boise, ID 83709-3075

Phone

(208) 917-2543

Fax

(208) 917-8598

NPI assigned

Jul 5, 2022

Organization subpart

No

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

Authorized official

Name

Merridith Manning, LMFTNPI 1235521253

Title

Member, Owner

Phone

(208) 917-2543

Specialties & licenses 3

Addresses

Practitioners 1

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

• Merridith Manning, LMFT

  • Marriage & Family Therapist
  • Boise, ID
  • NPI 1235521253
  NPD Authorized official

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1457084667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 E ODYSSEY ST",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345618",
            "telephone_number": "208-576-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 W OVERLAND RD STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837093075",
            "telephone_number": "208-917-2543",
            "fax_number": "208-917-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COUNSELING AND TREATMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "MERRIDITH",
        "authorized_official_title_or_position": "MEMBER, OWNER",
        "authorized_official_telephone_number": "208-917-2543",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Phillip Imperio
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• Incline Mental Health PLLC

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.