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General NPI Number Information
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NPI Number | 1902219512
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Entity Type | Organization
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Legal Business Name | TRANSFORMATIONS COUNSELING GROUP LCSW PLLC
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 1 RABRO DR STE 10
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City | HAUPPAUGE
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State | NY
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Zip | 11788-4270
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Country | US
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Telephone | 631-979-2775
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Fax |
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Provider Business Mailing Address
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Address Line | 269 E MAIN ST # F
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City | SMITHTOWN
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State | NY
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Zip | 11787-2832
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Country | US
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Telephone | 631-979-2775
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH BURNS
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Credential | LCSW
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Telephone | 631-257-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082535
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 027434
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License Number State | NY
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