| Transformation Behavioral Health Associates Llc | |
|
1090 Mcconnell Rd Woodstock IL 60098-7310 | |
| (815) 245-6669 | |
| (815) 334-1640 |
| Full Name | Transformation Behavioral Health Associates Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1090 Mcconnell Rd, Woodstock, Illinois |
| Authorized Official Name and Position | Kelly Vinehout (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8152456669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformation Behavioral Health Associates Llc Po Box 1861 Woodstock IL 60098-1861 Ph: (815) 245-6669 | Transformation Behavioral Health Associates Llc 1090 Mcconnell Rd Woodstock IL 60098-7310 Ph: (815) 245-6669 |
| NPI Number | 1710225644 |
|---|---|
| Provider Enumeration Date | 01/28/2013 |
| Last Update Date | 08/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710225644 | NPI | - | NPPES |
| 11894012 | Other | IL | CAQH |
| 600016119 | Other | IL | MAGELLAN |
| 35641736 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071006683 (Illinois) | Primary |
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