MEDICARE: TRANSFORMATIONS COUNSELING, INC

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	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1598282436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSFORMATIONS COUNSELING, INC

Provider Business Mailing Address
First Line	:	667 DELTONA BLVD STE 100
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-8151
Country	:	US
Telephone Number	:	386-479-9062
Fax Number	:	321-249-0741

Provider Business Practice Location Address
First Line	:	667 DELTONA BLVD STE 100
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32725-8151
Country	:	US
Telephone Number	:	386-479-9062
Fax Number	:	321-249-0741

Authorized Official
Title or Position	:	CO-OWNER
Name	:	PATRICIA PEACE
Credential	:	LMHC
Telephone Number	:	386-479-9062

Provider Enumeration Date	:	08/22/2017
Last Update Date	:	05/01/2019

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