Authentic Transformations LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60611766 Issued in WA

Legal business name

AUTHENTIC TRANSFORMATIONS LLC

Practice address

1112 11TH St Ste 301
Bellingham, WA 98225-6654

Phone

(360) 225-7073

NPI assigned

Dec 14, 2016

Last updated

Dec 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marcel Anthony Van EerdNPI 1114903705

Title

Executive Director

Phone

(480) 277-5919

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marcel A Van Eerd, PSY.D.

  • Clinical Psychologist
  • Bellingham, WA
  • NPI 1114903705
  NPD (past) Authorized official

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1053855734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 WESTHILLS PL",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982264174",
            "telephone_number": "480-277-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 11TH ST STE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982256654",
            "telephone_number": "360-225-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC TRANSFORMATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "VAN EERD",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-277-5919",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60611766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.