Active NPI
A Transforming Life Wellness Ctr LLC
- Mental Health Counselor
- Mayfield Village, OH
National Provider Identifier
1558801746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E0500069
- Legal business name
- A TRANSFORMING LIFE WELLNESS CTR LLC
- Practice address
- 781 Beta Dr
Suite K1
Mayfield Village, OH 44143-2356 - Phone
- (440) 565-7833
- Fax
- (440) 684-9030
- NPI assigned
- Mar 7, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Richardson, LPCC
- Title
- Ceo
- Phone
- (216) 702-8526
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E0500069 | OH | Primary |
Addresses
Primary practice location
781 Beta Dr
Suite K1
Mayfield Village, OH 44143-2356
Mailing address
7085 W 130TH St
#201A
Parma Heights, OH 44130-7851
Phone (440) 565-7833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 896347 | Medicaid | OH |
National Provider Directory
National Provider Directory- Tax ID family
- A Transforming Life Wellness Ctr LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Shaker HTS, OH
- NPI 1154571800
Locations
781 Beta Dr
Ste K1
Mayfield Village, OH 44143
Phone (440) 565-7833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488844800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1488844800000",
"number": "1558801746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7085 W 130TH ST",
"address_2": "#201A",
"city": "PARMA HEIGHTS",
"state": "OH",
"postal_code": "441307851",
"telephone_number": "440-565-7833",
"fax_number": "440-684-9030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "781 BETA DR",
"address_2": "SUITE K1",
"city": "MAYFIELD VILLAGE",
"state": "OH",
"postal_code": "441432356",
"telephone_number": "440-565-7833",
"fax_number": "440-684-9030"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "A TRANSFORMING LIFE WELLNESS CTR LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-07",
"last_updated": "2017-03-07",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "216-702-8526",
"authorized_official_credential": "LPCC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0500069",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "896347",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mayfield Village, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.