Provider Demographics
NPI:1649963208
Name:TRANSFORMING LIVES COUNSELING AND PRP SERVICES, LLC
Entity type:Organization
Organization Name:TRANSFORMING LIVES COUNSELING AND PRP SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:410-645-1000
Mailing Address - Street 1:1900 E NORTHERN PKWY STE T5
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2120
Mailing Address - Country:US
Mailing Address - Phone:410-645-1000
Mailing Address - Fax:667-205-1382
Practice Address - Street 1:1900 E NORTHERN PKWY STE T5
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-2120
Practice Address - Country:US
Practice Address - Phone:410-645-1000
Practice Address - Fax:667-205-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health