NPIMap

Organization Active NPI

Transformation Therapy Center Inc

  • Clinical Social Worker
  • Clinton, MD
National Provider Identifier
1609190750
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10425 Issued in MD
Legal business name
TRANSFORMATION THERAPY CENTER INC
Practice address
10401 Hospital Dr
Suite G-03
Clinton, MD 20735-3110
Phone
(301) 856-6000
Fax
(301) 856-8389
NPI assigned
Mar 18, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Mrs. Kellie I Jamison, MSWNPI 1083653968
Title
LC SW-C
Phone
(301) 856-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 04071 MD
Clinical Social Worker 1041C0700X 10425 MD Primary

Addresses

Primary practice location

10401 Hospital Dr
Suite G-03
Clinton, MD 20735-3110

Mailing address

10401 Hospital Dr
Suite G-03
Clinton, MD 20735-3110
Phone (301) 856-6000

Other identifiers 1

IdentifierTypeStateIssuer
10425OtherMDLICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1609190750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 HOSPITAL DR",
            "address_2": "SUITE G-03",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353110",
            "telephone_number": "301-856-6000",
            "fax_number": "301-856-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 HOSPITAL DR",
            "address_2": "SUITE G-03",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353110",
            "telephone_number": "301-856-6000",
            "fax_number": "301-856-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "LC SW-C",
        "authorized_official_telephone_number": "301-856-6000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04071",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10425",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.