Provider Demographics
NPI:1831419324
Name:TRANSITIONS BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:TRANSITIONS BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:608-617-5400
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901-0445
Mailing Address - Country:US
Mailing Address - Phone:608-617-5400
Mailing Address - Fax:
Practice Address - Street 1:317 DEWITT ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-2155
Practice Address - Country:US
Practice Address - Phone:608-617-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3590-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty