Provider Demographics
NPI:1205355898
Name:TRANSFORMATION TAKES TIME COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:TRANSFORMATION TAKES TIME COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:YASIM
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CSOTP
Authorized Official - Phone:804-277-7761
Mailing Address - Street 1:5911 WILLOW OAKS DR APT E
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-2428
Mailing Address - Country:US
Mailing Address - Phone:804-277-7761
Mailing Address - Fax:
Practice Address - Street 1:5911 WILLOW OAKS DRIVE APT E
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-2428
Practice Address - Country:US
Practice Address - Phone:804-277-7761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006598101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty