Healthcare Provider Details

I. General information

NPI: 1831772391
Provider Name (Legal Business Name): TRANSFORMATIONS THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 N BABCOCK ST STE 113
MELBOURNE FL
32935-6923
US

IV. Provider business mailing address

3052 CHICA CIR
WEST MELBOURNE FL
32904-6806
US

V. Phone/Fax

Practice location:
  • Phone: 321-210-3681
  • Fax:
Mailing address:
  • Phone: 321-210-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALISA MCGEE
Title or Position: THERAPIST COUNSELOR
Credential: LCSW
Phone: 321-210-3681