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General NPI Number Information
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NPI Number | 1063009744
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Entity Type | Organization
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Legal Business Name | TRANSFORMING YOUR TOMORROW, PLLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 6610 CRESCENT MOON CT
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City | RALEIGH
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State | NC
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Zip | 27606-5431
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Country | US
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Telephone | 919-659-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 6610 CRESCENT MOON CT APT 302
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City | RALEIGH
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State | NC
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Zip | 27606-3174
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMARA SMITH THOM
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Credential | LCMHC, LCAS
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Telephone | 919-659-5209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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