Provider Demographics
NPI:1164726964
Name:TRANSFORMATION COUNSELING LLC
Entity Type:Organization
Organization Name:TRANSFORMATION COUNSELING LLC
Other - Org Name:TRANSFORMATION COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CAADC, MAC, NCC
Authorized Official - Phone:972-757-4673
Mailing Address - Street 1:1221 W WHITEHALL RD
Mailing Address - Street 2:ALLIANCE BUILDING
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2627
Mailing Address - Country:US
Mailing Address - Phone:972-757-4673
Mailing Address - Fax:814-237-2777
Practice Address - Street 1:1221 W WHITEHALL RD
Practice Address - Street 2:1221 A
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2627
Practice Address - Country:US
Practice Address - Phone:972-757-4673
Practice Address - Fax:814-237-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA7252101YA0400X
101YP1600X
PAPC002386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty