NPIMap

Organization Active NPI

Impact Behavior Health Service

  • Community/Behavioral Health Agency
  • New Orleans, LA
National Provider Identifier
1669846879
Registry record updated Nov 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPACT BEHAVIOR HEALTH SERVICE
Doing business as
IMpact Behavior Health Service
Practice address
1406 Esplanade Ave
New Orleans, LA 70116-1803
Phone
(504) 304-4097
Fax
(504) 218-7962
NPI assigned
Nov 26, 2015
Last updated
Nov 26, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
IMPACT BEHAVIOR HEALTH SERVICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2015

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

Authorized official

Name
Mrs. Tracy Elizabeth Clark, MASTERNPI 1477907368
Title
Counselor
Phone
(504) 329-3755

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
Community/Behavioral Health Agency 251S00000X LA Primary

Addresses

Primary practice location

1406 Esplanade Ave
New Orleans, LA 70116-1803

Mailing address

1406 Esplanade Ave
New Orleans, LA 70116-1803
Phone (504) 304-4097

Other names 1

  • IMpact Behavior Health Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Impact Behavior Health Service3 organizations share this tax ID, including this one
Part of
Impact Behavior Health Services LLC

Other organizations with this tax ID 2

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": "1448496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448496000000",
    "number": "1669846879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 ESPLANADE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701161803",
            "telephone_number": "504-304-4097",
            "fax_number": "504-218-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 ESPLANADE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701161803",
            "telephone_number": "504-304-4097",
            "fax_number": "504-218-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIOR HEALTH SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMPACT BEHAVIOR HEALTH SERVICE",
        "enumeration_date": "2015-11-26",
        "last_updated": "2015-11-26",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "504-329-3755",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MASTER"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMpact Behavior Health Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.