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General NPI Number Information
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NPI Number | 1407431117
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIVE GROWTH LLC
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 630 KINGSLEY AVE STE 100-501
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City | ORANGE PARK
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State | FL
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Zip | 32073-5465
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Country | US
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Telephone | 630-423-6010
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Fax | 844-270-7898
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Provider Business Mailing Address
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Address Line | 24W500 MAPLE AVE STE 216A
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City | NAPERVILLE
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State | IL
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Zip | 60540-6003
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Country | US
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Telephone | 630-423-6010
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Fax | 844-270-7898
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JENNIFER BRENS
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Credential |
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Telephone | 630-423-6010
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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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