Provider Demographics
NPI:1639760259
Name:IMPACT HEALTH & WELLNESS
Entity type:Organization
Organization Name:IMPACT HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NARKAUS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:862-333-8230
Mailing Address - Street 1:350 S BROAD ST APT 305
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08608-2525
Mailing Address - Country:US
Mailing Address - Phone:862-333-8230
Mailing Address - Fax:
Practice Address - Street 1:100 CAMPUS TOWN CIR STE 103
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-1962
Practice Address - Country:US
Practice Address - Phone:973-953-9780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty