Healthcare Provider Details

I. General information

NPI: 1821846023
Provider Name (Legal Business Name): TRANSFORMATION HAVEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2024
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 SARNO RD STE 1
MELBOURNE FL
32935-3989
US

IV. Provider business mailing address

1801 SARNO RD STE 1
MELBOURNE FL
32935-3989
US

V. Phone/Fax

Practice location:
  • Phone: 321-622-4066
  • Fax: 321-306-2879
Mailing address:
  • Phone: 321-622-4066
  • Fax: 321-306-2879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TONIA LYNN MEYERS
Title or Position: EXECUTIVE DIRECTOR/FOUNDER
Credential: MA
Phone: 321-622-4066