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General NPI Number Information
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NPI Number | 1396123584
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Entity Type | Organization
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Legal Business Name | SUCCESSFUL TRANSITIONS LLC
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 301 N ELM ST 264
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City | GREENSBORO
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State | NC
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Zip | 27401-2083
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Country | US
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Telephone | 336-275-7973
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N ELM ST 264
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City | GREENSBORO
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State | NC
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Zip | 27401-2083
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Country | US
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Telephone | 336-275-7973
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | EVA WASHINGTON
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Credential | M.S. ED, CRC, LCAS-A
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Telephone | 336-312-7761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | A10756
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 20337
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License Number State | NC
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