Provider Demographics
NPI:1932729746
Name:TRANSFORMATIONS PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:TRANSFORMATIONS PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIETTE
Authorized Official - Middle Name:REDERSTORFF
Authorized Official - Last Name:SAVITSCUS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-584-5307
Mailing Address - Street 1:738 VIOLA DR
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-7601
Mailing Address - Country:US
Mailing Address - Phone:614-584-5307
Mailing Address - Fax:614-508-0724
Practice Address - Street 1:167 S STATE ST STE 80
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2236
Practice Address - Country:US
Practice Address - Phone:614-584-5307
Practice Address - Fax:614-508-0724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1245418250OtherPERSONAL NPI