NPIMap

Organization Active NPI

Transformation Wellness LLC

Doing business as Stella Luna Counseling and Wellness

  • Mental Health Counselor
  • Middleburg Heights, OH
National Provider Identifier
1033854658
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TRANSFORMATION WELLNESS LLC
Doing business as
Stella Luna Counseling and Wellness
Practice address
17951 Jefferson Park Rd Ste 100
Middleburg Heights, OH 44130-8439
Phone
(440) 879-8517
NPI assigned
Apr 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Lynne Digiandomenico, LPCCNPI 1457841322
Title
Owner
Phone
(440) 879-8517

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

17951 Jefferson Park Rd Ste 100
Middleburg Heights, OH 44130-8439

Mailing address

17951 Jefferson Park Rd Ste 100
Middleburg Heights, OH 44130-8439
Phone (440) 879-8517

Other practice location 1

18660 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3483
Phone (440) 879-8517

Other identifiers 1

IdentifierTypeStateIssuer
0000405MedicaidOH

Other names 1

  • Stella Luna Counseling and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221110001819 OH Part B Supplier - Clinic/Group Practice 2062889611 Receives reassigned benefits from 15 practitioners
Practice locations: Middleburg Heights, OH

National Provider Directory

National Provider Directory

Locations

17951 Jefferson Park Rd
Ste 100
Middleburg Heights, OH 44130
Phone (440) 879-8517

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1033854658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17951 JEFFERSON PARK RD STE 100",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441308439",
            "telephone_number": "440-879-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17951 JEFFERSON PARK RD STE 100",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441308439",
            "telephone_number": "440-879-8517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18660 Bagley Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Middleburg Heights",
            "state": "OH",
            "postal_code": "441303483",
            "country_code": "US",
            "telephone_number": "440-879-8517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRANSFORMATION WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "DIGIANDOMENICO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-879-8517",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000405",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stella Luna Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Stella Luna Counseling and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.