Healthcare Provider Details

I. General information

NPI: 1457148918
Provider Name (Legal Business Name): TRANSFORMED COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 RICHMOND ST
MOUNT VERNON KY
40456-2709
US

IV. Provider business mailing address

118 RAVENWOOD RD
ORLANDO KY
40460-7501
US

V. Phone/Fax

Practice location:
  • Phone: 606-256-3332
  • Fax:
Mailing address:
  • Phone: 606-416-2782
  • Fax:

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 Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER DALE MCGUIRE
Title or Position: OWNER
Credential:
Phone: 606-416-2782