MEDICARE: TRANSCENDENCE COUNSELING CENTER 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1326685660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSCENDENCE COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	1314 PORT MALABAR BLVD NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-5238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 17TH ST STE W
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5687
Country	:	US
Telephone Number	:	772-888-0212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA SINGH
Credential	:
Telephone Number	:	772-888-0212

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	12/05/2019

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