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

Impact Wellness Center LLC

Organization Mental Health Counselor · NPI 1205509205

Impact Wellness Center LLC is a Mental Health Counselor in North Chesterfield, Virginia. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2700 Galena Ave
North Chesterfield, VA 23237-4638
Phone: (702) 754-9136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Cognitive & Behavioral Psychologist Taxonomy 103TB0200X
Counseling Psychologist Taxonomy 103TC1900X
Intellectual & Developmental Disabilities Psychologist Taxonomy 103TM1800X

Record details

NPI number1205509205
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Stafford — Ceo · (702) 754-9063
NPI enumeratedJuly 27, 2021
Last updated in NPPESJuly 27, 2021
Certification dateJuly 27, 2021
Mailing address2700 Galena Ave, North Chesterfield, VA 23237-4638

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