Provider Demographics
NPI:1043587652
Name:TRANSFORMING LIFE CARE SERVICES LLC
Entity Type:Organization
Organization Name:TRANSFORMING LIFE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYNNELLE
Authorized Official - Middle Name:RENEE'
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-980-5763
Mailing Address - Street 1:509 BAY OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-4245
Mailing Address - Country:US
Mailing Address - Phone:804-980-5763
Mailing Address - Fax:
Practice Address - Street 1:509 BAY OAK DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-4245
Practice Address - Country:US
Practice Address - Phone:804-980-5763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-27
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040071881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty