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Intentional Impact Lmsw Pllc

NPI Registration Record

Provider / OrganizationNPIDate Certified
INTENTIONAL IMPACT LMSW PLLC11549035402021-04-25

The organization Intentional Impact Lmsw Pllc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1154903540. Registration indicates Intentional Impact Lmsw Pllc is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Mental Health (Including Community Mental Health Center),, ) (Community Mental Health Center, ) (Clinic/Center Mental Health (Including Community Mental Health Center),, Ambulatory Health Care Facilities) (Clinic/Center, )

Entity TypeOrganization
Provider OrganizationINTENTIONAL IMPACT LMSW PLLC
Practice Office Address1350 BUFFALO RD STE 18
ROCHESTER, NY US
Practice Office Telephone5852902224
Mailing Address547 CEDARWOOD TER
ROCHESTER, NY 146097154 US
Business Telephone5852902224
Authorized OfficialCASWELL VINCENT SMITH, OWNER
5852902224
Contact Endpoints
Simple Practice []https://intentional-impact-lmsw-pllc.clientsecure.me/Direct
HPT Codes
CodePractice
License No
State
261QM0801X PRIMARY
Ambulatory Health Care Facilities
Clinic/Center
Clinic/Center: Mental Health (Including Community Mental Health Center),

Community Mental Health Center

Clinic/Center Mental Health (Including Community Mental Health Center),
Ambulatory Health Care Facilities
Clinic/Center
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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