| Transform & Renew, Pllc | |
|
11550 W Interstate 10 Ste 235 San Antonio TX 78230-1066 | |
| (903) 312-2818 | |
| Not Available |
| Full Name | Transform & Renew, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 11550 W Interstate 10 Ste 235, San Antonio, Texas |
| Authorized Official Name and Position | Aimee Rhodes (MEMBER) |
| Authorized Official Contact | 9033122818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transform & Renew, Pllc 11550 W Interstate 10 Ste 235 San Antonio TX 78230-1066 Ph: (903) 312-2818 | Transform & Renew, Pllc 11550 W Interstate 10 Ste 235 San Antonio TX 78230-1066 Ph: (903) 312-2818 |
| NPI Number | 1528786381 |
|---|---|
| Provider Enumeration Date | 08/18/2022 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 9739530189 |
|---|---|
| Medicare Enrollment ID | O20240419001695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528786381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Aimee Monique Rhodes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508235839 PECOS PAC ID: 8820449267 Enrollment ID: I20240419002078 |
| Provider Name | Elizabeth Kaye Oldham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700157138 PECOS PAC ID: 4880033000 Enrollment ID: I20240503000888 |
| Provider Name | Kadean Ortiz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023871860 PECOS PAC ID: 1153843727 Enrollment ID: I20250324002495 |
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