| Transformation Counseling Services, Llc | |
|
4634 Colonel Fenwick Pl Upper Marlboro MD 20772-5940 | |
| (301) 627-3686 | |
| Not Available |
| Full Name | Transformation Counseling Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4634 Colonel Fenwick Pl, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Mekea C Anderson (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3016273686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformation Counseling Services, Llc 4634 Colonel Fenwick Pl Upper Marlboro MD 20772-5940 Ph: (301) 627-3686 | Transformation Counseling Services, Llc 4634 Colonel Fenwick Pl Upper Marlboro MD 20772-5940 Ph: (301) 627-3686 |
| NPI Number | 1255753646 |
|---|---|
| Provider Enumeration Date | 01/20/2014 |
| Last Update Date | 01/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255753646 | NPI | - | NPPES |
| 058853900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LC50078339 (District Of Columbia) | Secondary |
| 251S00000X | Community/behavioral Health | 13403 (Maryland) | Primary |
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