Provider Demographics
NPI:1821164187
Name:TRANSITIONS PSYCHOLOGY GROUP LLC
Entity Type:Organization
Organization Name:TRANSITIONS PSYCHOLOGY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CREED
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:970-336-1123
Mailing Address - Street 1:7251 W 20TH ST
Mailing Address - Street 2:BLDG M-2
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4626
Mailing Address - Country:US
Mailing Address - Phone:970-336-1123
Mailing Address - Fax:970-351-0182
Practice Address - Street 1:7251 W 20TH ST
Practice Address - Street 2:BLDG M-2
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4626
Practice Address - Country:US
Practice Address - Phone:970-336-1123
Practice Address - Fax:970-351-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01002562Medicaid
CO01002562Medicaid