Provider Demographics
NPI:1578624268
Name:INNER TRANSFORMATIONS, LLC
Entity Type:Organization
Organization Name:INNER TRANSFORMATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:CURRI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-521-4955
Mailing Address - Street 1:600 AVENIDA VILLAHERMOSA
Mailing Address - Street 2:UNIT #207
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 LENA STREET
Practice Address - Street 2:BUILDING 'C', SUITE 3
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:203-521-4955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CTLCSW 0003201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty