Provider Demographics
NPI:1659743847
Name:TRANSFORMATIONS, LLC
Entity Type:Organization
Organization Name:TRANSFORMATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SOTHIA
Authorized Official - Middle Name:LASHAN
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-613-6043
Mailing Address - Street 1:4303 W VILLAGE AVE
Mailing Address - Street 2:APT 5005
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-5226
Mailing Address - Country:US
Mailing Address - Phone:301-613-6043
Mailing Address - Fax:301-576-3671
Practice Address - Street 1:4303 MIDTOWN SQ
Practice Address - Street 2:SUITE 5005
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4427
Practice Address - Country:US
Practice Address - Phone:301-613-6043
Practice Address - Fax:301-576-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA 341101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty