Impact Counseling & Support Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

IMPACT COUNSELING & SUPPORT SERVICES LLC

Practice address

1901 Manhattan Blvd BLDG D306
Harvey, LA 70058-3582

Phone

(504) 250-1888

NPI assigned

Apr 5, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Tyshica Rhodes Lofton, LCSW

Title

Clinical Director/Ceo

Phone

(505) 301-6330

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1639675820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 AUTUMN LAKES RD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615106",
            "telephone_number": "504-301-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MANHATTAN BLVD BLDG D306",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700583582",
            "telephone_number": "504-250-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COUNSELING & SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "LOFTON",
        "authorized_official_first_name": "TYSHICA",
        "authorized_official_middle_name": "RHODES",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "505-301-6330",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Harvey, LA
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• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.