Healthcare Provider Details

I. General information

NPI: 1437891587
Provider Name (Legal Business Name): TRANSFORMATIVE BEGINNINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 WINTERSON RD STE 200-LH49
LINTHICUM HEIGHTS MD
21090-2209
US

IV. Provider business mailing address

1190 WINTERSON RD STE 200-LH49
LINTHICUM HEIGHTS MD
21090-2209
US

V. Phone/Fax

Practice location:
  • Phone: 667-415-6545
  • Fax: 443-381-0715
Mailing address:
  • Phone: 667-415-6545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ESPERANZA BALLENILLA
Title or Position: OWNER
Credential:
Phone: 253-886-7324