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General NPI Number Information
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NPI Number | 1710522842
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Entity Type | Organization
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Legal Business Name | TRANSFORMING MINDS THERAPEUTIC COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 253 RICHMOND POINTE WAY
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City | RICHLAND
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State | MS
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Zip | 39218-6601
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Country | US
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Telephone | 601-720-9945
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Fax |
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Provider Business Mailing Address
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Address Line | 108 CHARTLEIGH CIR
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City | CANTON
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State | MS
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Zip | 39046-1210
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Country | US
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Telephone | 601-720-9945
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | TASHINIKA CROWLEY
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Credential | LPC
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Telephone | 601-720-9945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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