Provider Demographics
NPI:1720690050
Name:TRANSCENDENT TELEMEDICINE PRACTICE LLC
Entity Type:Organization
Organization Name:TRANSCENDENT TELEMEDICINE PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,FNP-BC, PMHNP-BC
Authorized Official - Phone:216-233-1983
Mailing Address - Street 1:5241 WILSON MILLS RD STE 35C
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2150
Mailing Address - Country:US
Mailing Address - Phone:440-221-2449
Mailing Address - Fax:440-448-4912
Practice Address - Street 1:5241 WILSON MILLS RD STE 35C
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2150
Practice Address - Country:US
Practice Address - Phone:440-221-2449
Practice Address - Fax:440-448-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty