Healthcare Provider Details

I. General information

NPI: 1447906110
Provider Name (Legal Business Name): CENTER FOR TRANSFORMATIVE HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 OLIVE ST
EUGENE OR
97401-3547
US

IV. Provider business mailing address

1188 OLIVE ST
EUGENE OR
97401-3547
US

V. Phone/Fax

Practice location:
  • Phone: 503-272-1750
  • Fax:
Mailing address:
  • Phone: 503-272-1750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1992008684
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerNPI

VIII. Authorized Official

Name: DR. DEANNA LINVILLE
Title or Position: CO-OWNER
Credential: PHD, LMFT
Phone: 503-272-1750