Provider Demographics
NPI:1023529385
Name:TRANSFORMING LIVES COUNSELING SERVICE, LLC
Entity type:Organization
Organization Name:TRANSFORMING LIVES COUNSELING SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSHANDA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-368-6265
Mailing Address - Street 1:5585 PERSHING AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-1850
Mailing Address - Country:US
Mailing Address - Phone:314-368-6265
Mailing Address - Fax:314-328-0036
Practice Address - Street 1:5585 PERSHING AVE # 130
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-4621
Practice Address - Country:US
Practice Address - Phone:314-368-6265
Practice Address - Fax:314-261-5013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No102X00000XBehavioral Health & Social Service ProvidersPoetry TherapistGroup - Multi-Specialty