Provider Demographics
NPI:1841009735
Name:WHOLISTIC TRANSFORMATION, LLC
Entity type:Organization
Organization Name:WHOLISTIC TRANSFORMATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-937-3324
Mailing Address - Street 1:9706 BRIERTOWNES PKWY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4217
Mailing Address - Country:US
Mailing Address - Phone:919-937-3324
Mailing Address - Fax:
Practice Address - Street 1:2828 PICKETT RD STE 250E
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-5877
Practice Address - Country:US
Practice Address - Phone:919-937-3324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical