Provider Demographics
NPI:1710607635
Name:POSITIVE TRANSFORMATION PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:POSITIVE TRANSFORMATION PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL-PHILIPPE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE-PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-418-2673
Mailing Address - Street 1:11828 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4345
Mailing Address - Country:US
Mailing Address - Phone:954-627-2149
Mailing Address - Fax:
Practice Address - Street 1:11828 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4345
Practice Address - Country:US
Practice Address - Phone:954-627-2149
Practice Address - Fax:954-212-8154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty