Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Impact Community Resources

Organization Mental Health Counselor · NPI 1356069264

Impact Community Resources is a Mental Health Counselor in Charlotte, North Carolina. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
13
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Practice location Address checks out

301 McCullough Dr
Charlotte, NC 28262-3310
Phone: (980) 276-5142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Mental Health Counselor Taxonomy 101YM0800X
School Counselor Taxonomy 101YS0200X
Case Management Agency Taxonomy 251B00000X
In Home Supportive Care Agency Taxonomy 253Z00000X
Developmental Disabilities Clinic/Center Taxonomy 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X
Adult Mental Health Clinic/Center Taxonomy 261QM0850X
Adolescent and Children Mental Health Clinic/Center Taxonomy 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X
Non-emergency Medical Transport (VAN) Taxonomy 343900000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X
Respite Care Taxonomy 385H00000X

Record details

NPI number1356069264
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carlita Randall — Clinical Director · (412) 977-1273
NPI enumeratedAugust 16, 2022
Last updated in NPPESJune 4, 2025
Certification dateJune 4, 2025
Mailing address7911 Bella Vista Ct, Charlotte, NC 28216-2044

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