MEDICARE: TRANSITIONING NORTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1285307546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONING NORTH

Provider Business Mailing Address
First Line	:	1917 MITCHELL ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-4301
Country	:	US
Telephone Number	:	202-415-9085
Fax Number	:

Provider Business Practice Location Address
First Line	:	1917 MITCHELL ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-4301
Country	:	US
Telephone Number	:	202-415-9085
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SHAMBRICKA DENISE NORTH
Credential	:	LISW-CP
Telephone Number	:	202-415-9085

Provider Enumeration Date	:	07/31/2021
Last Update Date	:	07/31/2021

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Directions to “TRANSITIONING NORTH ” Practice Location

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