Provider Demographics
NPI:1679451454
Name:TRANSFORMATION COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:TRANSFORMATION COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DERDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-503-5262
Mailing Address - Street 1:10752 DEERWOOD PARK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4846
Mailing Address - Country:US
Mailing Address - Phone:904-503-5262
Mailing Address - Fax:904-895-5748
Practice Address - Street 1:10752 DEERWOOD PARK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4846
Practice Address - Country:US
Practice Address - Phone:904-503-5262
Practice Address - Fax:904-895-5748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty