Healthcare Provider Details

I. General information

NPI: 1730138975
Provider Name (Legal Business Name): TRANSITIONS COUNSELING & SUPPORT SERVICES FOR FAMILIES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 C ST
BEDFORD IN
47421-4316
US

IV. Provider business mailing address

PO BOX 213
BEDFORD IN
47421-0213
US

V. Phone/Fax

Practice location:
  • Phone: 812-275-7765
  • Fax: 812-275-6520
Mailing address:
  • Phone: 812-275-7765
  • Fax: 812-275-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number57000122A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number57000122A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number57000122A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number57000122A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number57000122A
License Number StateIN
# 6
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number95000122A
License Number StateIN

VIII. Authorized Official

Name: DR. KIMBERLEY A. GREEN
Title or Position: PRESIDENT
Credential: PH.D., HSPP
Phone: 812-275-7765