Provider Demographics
NPI:1689204299
Name:TRANSFORMATION COUNSELING AND ASSESSMENT CENTER
Entity Type:Organization
Organization Name:TRANSFORMATION COUNSELING AND ASSESSMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONE-VESPA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LPC
Authorized Official - Phone:215-500-4924
Mailing Address - Street 1:3817 NATHAN LN
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-7003
Mailing Address - Country:US
Mailing Address - Phone:155-004-9242
Mailing Address - Fax:
Practice Address - Street 1:663 N MAIN RD
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8204
Practice Address - Country:US
Practice Address - Phone:215-500-4924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty