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General NPI Number Information
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NPI Number | 1861156507
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Entity Type | Organization
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Legal Business Name | TRANSFORMING LIVES CONSULTANT FIRM LLC
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 201 CENTURY VILLAGE BLVD STE 234
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City | MONROE
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State | LA
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Zip | 71203-2008
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Country | US
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Telephone | 318-914-2632
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Fax | 318-855-3998
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Provider Business Mailing Address
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Address Line | 201 CENTURY VILLAGE BLVD STE 234
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City | MONROE
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State | LA
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Zip | 71203-2008
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Country | US
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Telephone | 318-914-2632
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Fax | 318-855-3998
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Authorized Official
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Title or Position | CAC/MHP
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Name | TAMERA TAYLOR
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Credential | CAC
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Telephone | 318-914-2632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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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