Provider Demographics
NPI:1124988506
Name:POSITIVE IMPACT SOLUTION
Entity type:Organization
Organization Name:POSITIVE IMPACT SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-926-9386
Mailing Address - Street 1:4749 LINCOLN MALL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-3806
Mailing Address - Country:US
Mailing Address - Phone:312-857-6175
Mailing Address - Fax:773-901-3764
Practice Address - Street 1:4749 LINCOLN MALL DR STE 100
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-3806
Practice Address - Country:US
Practice Address - Phone:312-857-6175
Practice Address - Fax:773-901-3764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty