Healthcare Provider Details

I. General information

NPI: 1972019560
Provider Name (Legal Business Name): TRANSCENDING MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 01/10/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 N TRIUMPH BLVD
LEHI UT
84043-5023
US

IV. Provider business mailing address

409 CHATEAU DR
HENDERSON NV
89002-8345
US

V. Phone/Fax

Practice location:
  • Phone: 702-726-0637
  • Fax:
Mailing address:
  • Phone: 702-726-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7074-C
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADRIENNE RANDALL
Title or Position: OWNER/LCSW
Credential:
Phone: 702-726-0637