Provider Demographics
NPI:1881038131
Name:TRANSFORMED MINDZ COUNSELING SERVICES
Entity Type:Organization
Organization Name:TRANSFORMED MINDZ COUNSELING SERVICES
Other - Org Name:LM SENIORCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/LIFE COACH
Authorized Official - Prefix:DR
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:THD
Authorized Official - Phone:903-215-3761
Mailing Address - Street 1:401 JET DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75603-9498
Mailing Address - Country:US
Mailing Address - Phone:903-215-3761
Mailing Address - Fax:
Practice Address - Street 1:401 JET DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75603-9498
Practice Address - Country:US
Practice Address - Phone:903-215-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty