Provider Demographics
NPI:1174664973
Name:TRANSITIONS, PROVIDING SUPPORT FOR CHANGE
Entity Type:Organization
Organization Name:TRANSITIONS, PROVIDING SUPPORT FOR CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-396-1365
Mailing Address - Street 1:17 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3245
Mailing Address - Country:US
Mailing Address - Phone:717-396-1365
Mailing Address - Fax:717-396-1365
Practice Address - Street 1:255 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6308
Practice Address - Country:US
Practice Address - Phone:717-396-1365
Practice Address - Fax:717-396-1365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006493L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
127082Medicare ID - Type Unspecified