=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013471358
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRANSCENDENCE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2019
-----------------------------------------------------
Last Update Date | 01/30/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 810 PRINCETON PKWY STE B
-----------------------------------------------------
City | OWENSBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42301-6166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-204-4035
-----------------------------------------------------
Fax | 270-204-4035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 PRINCETON PKWY STE B
-----------------------------------------------------
City | OWENSBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42301-6166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-204-4035
-----------------------------------------------------
Fax | 270-204-4035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST/OWNER
-----------------------------------------------------
Name | ELIZABETH ANNE BROWN
-----------------------------------------------------
Credential | LPCC
-----------------------------------------------------
Telephone | 270-316-1917
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------