Impact Me Addiction Counseling Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IMPACT ME ADDICTION COUNSELING SERVICES

Practice address

303 Washington St W Ste 205
Charleston, WV 25302-2230

Phone

(681) 265-1140

NPI assigned

Apr 23, 2021

Organization subpart

No

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

Authorized official

Name

Seri Bosse

Title

Owner

Phone

(681) 265-1140

Specialties & licenses 3

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1467034058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 WASHINGTON ST W STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022230",
            "telephone_number": "681-265-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 WASHINGTON ST W STE 205",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022230",
            "telephone_number": "681-265-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT ME ADDICTION COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "BOSSE",
        "authorized_official_first_name": "SERI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "681-265-1140"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Terenest",
            "affiliation": "N",
            "address_1": "303 Washington St W Ste 205",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253022230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Behavioral Health Agency in Charleston, WV
• Providers in Charleston, WV by specialty
• Community/Behavioral Health Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.