NPIMap

Organization Active NPI

Impact Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rhinelander, WI
National Provider Identifier
1740425941
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
42221700 Issued in WI
Legal business name
IMPACT COUNSELING SERVICES, LLC
Practice address
17A W Davenport St
Rhinelander, WI 54501-0742
Phone
(715) 369-6955
NPI assigned
Dec 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Mr. John A Hinz
Title
Business Manager
Phone
(715) 369-6955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 42221700 WI Primary

Addresses

Primary practice location

17A W Davenport St
Rhinelander, WI 54501-0742

Mailing address

PO Box 13251
15655 County Road B
Hayward, WI 54843-3251
Phone (715) 634-0607

Other identifiers 1

IdentifierTypeStateIssuer
42221700MedicaidWI

Other names 1

  • ICS-Family Partners Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Impact Counseling Services LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

17A W Davenport St
Rhinelander, WI 54501
Phone (715) 369-6955

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1740425941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13251",
            "address_2": "15655 COUNTY ROAD B",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433251",
            "telephone_number": "715-634-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17A W DAVENPORT ST",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545010742",
            "telephone_number": "715-369-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "HINZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "715-369-6955",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "42221700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42221700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICS-Family Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rhinelander, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.