DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SPECTRUM TRANSFORMATION GROUP, LLC

MEDICARE: SPECTRUM TRANSFORMATION GROUP, 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
1103TB0200XCognitive & Behavioral PsychologistVA
2103TC2200XClinical Child & Adolescent PsychologistVA
3103K00000XBehavior Analyst161707010VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11174855985OTHERVANPI

General Provider Information

NPI Number : 1639560741
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECTRUM TRANSFORMATION GROUP, LLC
Provider Business Mailing Address
First Line : 221 STONEBRIDGE PLAZA AVE STE C
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-6972
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 221 STONEBRIDGE PLAZA AVE STE C
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-6972
Country : US
Telephone Number : 804-378-6141
Fax Number :
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : DR. CEDRIC A MOORE JR.
Credential :
Telephone Number : 804-378-6141
Provider Enumeration Date : 02/11/2015
Last Update Date : 03/24/2020

Similar Medicare Providers

1083874051 — TRACEY FATZINGER PH.D.
Practice Location Address:
221 STONEBRIDGE PLAZA AVE
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax: 804-378-6183
1174855985 — SPECTRUM TRANSFORMATION GROUP, LLC
Practice Location Address:
221 STONEBRIDGE PLAZA AVE STE C
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax:
1033627963 — JAN MICHAEL LLANDA
Practice Location Address:
221 STONEBRIDGE PLAZA AVE
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax:
1871091231 — SHERILYN R PATTERSON MS
Practice Location Address:
221 STONEBRIDGE PLAZA AVE
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax:
1215418876 — TING BENTLEY BCBA
Practice Location Address:
221 STONEBRIDGE PLAZA AVE
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax:
1497372734 — MRS. COURTNEY HANNON KUMAR PMHNP
Practice Location Address:
221 STONEBRIDGE PLAZA AVE # ACE
NORTH CHESTERFIELD, VA
23225-6972
Practice Phone: 804-378-6141
Practice Fax:

Directions to “SPECTRUM TRANSFORMATION GROUP, 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.