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General NPI Number Information
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NPI Number | 1669285227
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL TRANSFORMATIONS PLLC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 9742 SUNNYWOOD DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-7965
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Country | US
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Telephone | 269-873-1878
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Fax |
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Provider Business Mailing Address
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Address Line | 9742 SUNNYWOOD DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-7965
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Country | US
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Telephone | 269-873-1878
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JILL ANN GREEN-BROWN
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Credential | LLP
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Telephone | 269-873-1878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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