Provider Demographics
NPI:1063128288
Name:TRANSFORMATION COUNSELING, CONSULTATION AND COACHING, LLC /'TC3'
Entity type:Organization
Organization Name:TRANSFORMATION COUNSELING, CONSULTATION AND COACHING, LLC /'TC3'
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:704-303-3554
Mailing Address - Street 1:90 DEER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3129
Mailing Address - Country:US
Mailing Address - Phone:704-303-3554
Mailing Address - Fax:
Practice Address - Street 1:90 DEER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3129
Practice Address - Country:US
Practice Address - Phone:170-430-3355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health