Healthcare Provider Details

I. General information

NPI: 1790424752
Provider Name (Legal Business Name): TRANSCENDENCE THERAPY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2022
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E SILVER SPRING DR STE 206
WHITEFISH BAY WI
53217-4704
US

IV. Provider business mailing address

8415 N PELICAN LN
RIVER HILLS WI
53217-2059
US

V. Phone/Fax

Practice location:
  • Phone: 414-885-0033
  • Fax:
Mailing address:
  • Phone: 262-977-0119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: NATALIE HANSON
Title or Position: OWNER AND PSYCHOTHERAPIST
Credential: LPC
Phone: 262-977-0119