Provider Demographics
NPI:1740080324
Name:TRANSFORMED PSYCHIATRIC WELLNESS LLC
Entity type:Organization
Organization Name:TRANSFORMED PSYCHIATRIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:MEDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:816-683-1996
Mailing Address - Street 1:2800 W 76 COUNTRY BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2170
Mailing Address - Country:US
Mailing Address - Phone:816-683-1996
Mailing Address - Fax:816-683-1996
Practice Address - Street 1:2800 W 76 COUNTRY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2170
Practice Address - Country:US
Practice Address - Phone:816-683-1996
Practice Address - Fax:816-683-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty