Provider Demographics
NPI:1588993950
Name:POSITIVE TRANSITIONS, INC.
Entity type:Organization
Organization Name:POSITIVE TRANSITIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-458-0570
Mailing Address - Street 1:2670 UNION AVE EXTENDED
Mailing Address - Street 2:STE 1224
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-4416
Mailing Address - Country:US
Mailing Address - Phone:901-458-0570
Mailing Address - Fax:901-458-5929
Practice Address - Street 1:2670 UNION AVE EXTENDED
Practice Address - Street 2:STE 1224
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-4416
Practice Address - Country:US
Practice Address - Phone:901-458-0570
Practice Address - Fax:901-458-5929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000001061104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3696560Medicaid
TN3696560Medicaid