Transformational Healthcare Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TRANSFORMATIONAL HEALTHCARE SERVICES

Practice address

123 Highland Ave Ste G2-a
Glen Ridge, NJ 07028-1527

Phone

(888) 344-4549

Fax

(908) 652-9230

NPI assigned

Aug 4, 2020

Last updated

Feb 12, 2024By 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

Simeon Mertyl

Title

Ceo President

Phone

(888) 344-4549

Specialties & licenses 12

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

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.

• Carolina Deniece Thompson, PSY.D.

  • Clinical Psychologist
  • Houston, TX
  • NPI 1154706406
  Medicare reassignment NPD
• Dione Nicole Johnson, PH.D.

  • Clinical Psychologist
  • Willingboro, NJ
  • NPI 1912044595
  NPD
• Alexandra D'Elia, RDN

  • Registered Dietitian
  • Staten Island, NY
  • NPI 1922558790
  NPD
• Nancy Dessources Adegoke, PH.D

  • Psychologist
  • New York, NY
  • NPI 1154503191
  NPD

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1669082756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TOWN SQUARE PLACE",
            "address_2": "SUITE 1203 PMB 1039",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073102784",
            "telephone_number": "888-344-4549",
            "fax_number": "908-652-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE STE G2-A",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "888-344-4549",
            "fax_number": "908-652-9230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Town Square Place",
            "address_2": "Suite 1203 PMB 1039",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "07310",
            "country_code": "US",
            "telephone_number": "888-344-4549",
            "fax_number": "908-652-9230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRANSFORMATIONAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-04",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "MERTYL",
        "authorized_official_first_name": "SIMEON",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "888-344-4549"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryerll Socorro Teves, APN
• Louis John Theodorou Jr., DMD, FAGD
• THS Nutritional Navigators
• Dennis A Tobia, M.D.
• Stephanie Toro
• Transformational Healthcare Services
• Ellen E Urrutia, MD
• John J Vaccaro, MD
• Christopher Valerian, D.O.
• Vernonway Healthcare Agency (Transformational Healthcare Services)

• Mental Health Counselor in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.