MEDICARE: TOTAL TRANSFORMATION COUNSELING, PLLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1215626742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL TRANSFORMATION COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	7436 OAKLAND ST # 1205
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48211-1352
Country	:	US
Telephone Number	:	248-238-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	28024 GREENING ST
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3718
Country	:	US
Telephone Number	:	248-238-8433
Fax Number	:

Authorized Official
Title or Position	:	OWNER , THERAPIST
Name	:	LATOYA DUMAS
Credential	:	LMSW
Telephone Number	:	248-238-8433

Provider Enumeration Date	:	05/02/2023
Last Update Date	:	05/02/2023

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