MEDICARE: TRANSFORM & THRIVE 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1316813587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSFORM & THRIVE COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	1500 N GRANT ST STE R
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 N GRANT ST STE R
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1859
Country	:	US
Telephone Number	:	720-796-9785
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MALIA JACKSON
Credential	:	LPC
Telephone Number	:	720-796-9785

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	01/12/2026

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