Healthcare Provider Details

I. General information

NPI: 1093338113
Provider Name (Legal Business Name): TRANSFORMATIVE THERAPY & CONSULTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COVINGTON CT LOWR LEVEL
LANSING MI
48912-4941
US

IV. Provider business mailing address

2929 COVINGTON CT LOWR LEVEL
LANSING MI
48912-4941
US

V. Phone/Fax

Practice location:
  • Phone: 517-798-6745
  • Fax:
Mailing address:
  • Phone: 517-798-6745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PARKER TERESE CURTIS
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 517-574-0488