NPIMap

Organization Active NPI

Transformations of Statesboro LLC

  • Addiction (Substance Use Disorder) Counselor
  • Statesboro, GA
National Provider Identifier
1518436179
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
TRANSFORMATIONS OF STATESBORO LLC
Practice address
326 Myrtle Crossing Dr Ste 300
Statesboro, GA 30458-4429
Phone
(912) 243-9310
Fax
(912) 243-9311
NPI assigned
Nov 13, 2018
Last updated
Nov 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Mr. Raymond Selwyn Scott, CAC II, CCSNPI 1023587706
Title
Ceo/Owner
Phone
(912) 243-9310

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

326 Myrtle Crossing Dr Ste 300
Statesboro, GA 30458-4429

Mailing address

326 Myrtle Crossing Dr Ste 300
Statesboro, GA 30458-4429
Phone (912) 243-9310

National Provider Directory

National Provider Directory

Locations

326 Myrtle Crossing Dr
Ste 300
Statesboro, GA 30458
Phone (912) 243-9310

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1518436179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 MYRTLE CROSSING DR STE 300",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584429",
            "telephone_number": "912-243-9310",
            "fax_number": "912-243-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 MYRTLE CROSSING DR STE 300",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584429",
            "telephone_number": "912-243-9310",
            "fax_number": "912-243-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIONS OF STATESBORO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "SELWYN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "912-243-9310",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAC II, CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.