Healthcare Provider Details

I. General information

NPI: 1932728748
Provider Name (Legal Business Name): TRANSFORMATIVE COUNSELING AND TRAUMA HEALING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2020
Last Update Date: 02/10/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7155 W CAMPO BELLO DR STE B110
GLENDALE AZ
85308-8594
US

IV. Provider business mailing address

7155 W CAMPO BELLO DR STE B110
GLENDALE AZ
85308-8594
US

V. Phone/Fax

Practice location:
  • Phone: 623-218-6030
  • Fax: 623-218-6230
Mailing address:
  • Phone: 623-218-6030
  • Fax: 623-218-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARBARA J PLOURD
Title or Position: OWNER
Credential: LPC
Phone: 602-473-8284