Provider Demographics
NPI:1790155240
Name:TRANSFORMATIONS, LLC
Entity Type:Organization
Organization Name:TRANSFORMATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:301-613-6043
Mailing Address - Street 1:5211 AUTH RD
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4339
Mailing Address - Country:US
Mailing Address - Phone:301-613-6043
Mailing Address - Fax:
Practice Address - Street 1:5211 AUTH RD
Practice Address - Street 2:SUITE 202B
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4339
Practice Address - Country:US
Practice Address - Phone:301-761-3614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty