Provider Demographics
NPI:1912632217
Name:TRANSFORMATIVE COUNSELING & WELLNESS LLC
Entity type:Organization
Organization Name:TRANSFORMATIVE COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:219-508-7045
Mailing Address - Street 1:4841 INDUSTRIAL PKWY UNIT 105
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-2929
Mailing Address - Country:US
Mailing Address - Phone:219-508-7045
Mailing Address - Fax:
Practice Address - Street 1:7 STONEGATE DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-8585
Practice Address - Country:US
Practice Address - Phone:219-561-0980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty