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NPI Code Detail

MEDICARE: TRANSFORMATION WELLNESS LLC

MEDICARE: TRANSFORMATION WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033854658
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSFORMATION WELLNESS LLC
Provider Business Mailing Address
First Line : 17951 JEFFERSON PARK RD STE 100
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-8439
Country : US
Telephone Number : 440-879-8517
Fax Number :
Provider Business Practice Location Address
First Line : 17951 JEFFERSON PARK RD STE 100
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-8439
Country : US
Telephone Number : 440-879-8517
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JENNIFER LYNNE DIGIANDOMENICO
Credential : LPCC
Telephone Number : 440-879-8517
Provider Enumeration Date : 04/28/2022
Last Update Date : 11/21/2022

Similar Medicare Providers

1750815452 — BROCK OWEN BODENBENDER LPCC
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax:
1285154625 — MR. JOSEPH J FATH M.ED, LPCC
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax:
1457841322 — MRS. JENNIFER LYNNE DIGIANDOMENICO LPCC
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax:
1164171096 — HEATHER L ANDERSON BOLL LPC
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax:
1588384317 — MALLORY CHAGNON
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax:
1558084566 — KALEIGH SAMF APRN, PMHNP-BC
Practice Location Address:
17951 JEFFERSON PARK RD STE 100
MIDDLEBURG HEIGHTS, OH
44130-8439
Practice Phone: 440-879-8517
Practice Fax: 440-445-0879

Directions to “TRANSFORMATION WELLNESS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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