Provider Demographics
NPI:1932685542
Name:TRANSFORMATIONS COUNSELING PLLC
Entity Type:Organization
Organization Name:TRANSFORMATIONS COUNSELING PLLC
Other - Org Name:TRANSFORMATIONS COUNSELING TRAINING AND CONSULTING LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LCPC CRADC
Authorized Official - Phone:815-222-3958
Mailing Address - Street 1:9861 ABERDEEN LN
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-2433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6066 STRATHMOOR DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6633
Practice Address - Country:US
Practice Address - Phone:815-324-3979
Practice Address - Fax:779-210-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007240101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty