| The Transformation Collective Llc | |
|
1154 Riverside Ave Unit 5 Somerset MA 02726-2841 | |
| (800) 735-8951 | |
| Not Available |
| Full Name | The Transformation Collective Llc |
|---|---|
| Speciality | Counselor |
| Location | 1154 Riverside Ave Unit 5, Somerset, Massachusetts |
| Authorized Official Name and Position | Mary C Obrien (OWNER) |
| Authorized Official Contact | 8007358951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Transformation Collective Llc 36 Hornbine Rd Swansea MA 02777-3618 Ph: (800) 735-8951 | The Transformation Collective Llc 1154 Riverside Ave Unit 5 Somerset MA 02726-2841 Ph: (800) 735-8951 |
| NPI Number | 1619717089 |
|---|---|
| Provider Enumeration Date | 05/31/2024 |
| Last Update Date | 05/31/2024 |
| Certification Date | 05/31/2024 |
| Medicare PECOS PAC ID | 5496280182 |
|---|---|
| Medicare Enrollment ID | O20241118003122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619717089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Mary C O'brien |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689075913 PECOS PAC ID: 7315472024 Enrollment ID: I20241118004086 |
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