| Therapeutic Transformations Llc | |
|
970 Bloomfield Rd Bardstown KY 40004-9708 | |
| (270) 234-6695 | |
| Not Available |
| Full Name | Therapeutic Transformations Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 970 Bloomfield Rd, Bardstown, Kentucky |
| Authorized Official Name and Position | Cassady Cobb (OWNER) |
| Authorized Official Contact | 2702346695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Transformations Llc Po Box 374 New Haven KY 40051-0374 Ph: (270) 234-6695 | Therapeutic Transformations Llc 970 Bloomfield Rd Bardstown KY 40004-9708 Ph: (270) 234-6695 |
| NPI Number | 1639682909 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 05/07/2019 |
| Medicare PECOS PAC ID | 5092078964 |
|---|---|
| Medicare Enrollment ID | O20180406002425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639682909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Linda M Block-coalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598750689 PECOS PAC ID: 2769442268 Enrollment ID: I20050105000379 |
| Provider Name | Carol S Mclennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477601474 PECOS PAC ID: 7012045602 Enrollment ID: I20100430000555 |
| Provider Name | Mckenzie Linton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003246422 PECOS PAC ID: 2163659079 Enrollment ID: I20131223000906 |
| Provider Name | Debra A Owens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124452099 PECOS PAC ID: 6901105642 Enrollment ID: I20160429001741 |
| Provider Name | Cassady Dawn Cobb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487028544 PECOS PAC ID: 6901169879 Enrollment ID: I20180410001124 |
| Provider Name | Deborah Reed |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437336682 PECOS PAC ID: 1951635408 Enrollment ID: I20190703000542 |
| Provider Name | Prudence Zollinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326025891 PECOS PAC ID: 4688655822 Enrollment ID: I20200131001493 |
| Provider Name | Candice N. Speiden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992223036 PECOS PAC ID: 7012330780 Enrollment ID: I20200714001352 |
| Provider Name | Stacey D Zimmerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225595515 PECOS PAC ID: 8426447319 Enrollment ID: I20211115002679 |
| Provider Name | Corinne E Hagan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780070250 PECOS PAC ID: 0244608578 Enrollment ID: I20221117002499 |
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