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General NPI Number Information
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NPI Number | 1134816705
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Entity Type | Organization
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Legal Business Name | TRANSCEND THERAPEUTICS LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 4380 67TH DR
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City | UNION GROVE
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State | WI
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Zip | 53182-9338
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Country | US
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Telephone | 262-397-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 4380 67TH DR # 1028
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City | UNION GROVE
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State | WI
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Zip | 53182-9338
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Country | US
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Telephone | 262-705-0610
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA OLSON
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Credential | LMFT, SAC
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Telephone | 262-397-9122
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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