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General NPI Number Information
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NPI Number | 1356191282
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIONAL THERAPY PLLC
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 7500 212TH ST SW STE 106
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City | EDMONDS
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State | WA
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Zip | 98026-7614
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Country | US
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Telephone | 206-852-7304
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Fax |
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Provider Business Mailing Address
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Address Line | 4705 226TH ST SW
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-4415
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Country | US
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Telephone | 120-685-2730
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MRS. CORAL LYNN BLANKINSHIP
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Credential | MSW, LICSW
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Telephone | 206-852-7304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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