Provider Demographics
NPI:1033947007
Name:TRANSFORMATIVE THERAPY
Entity type:Organization
Organization Name:TRANSFORMATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BONDSHU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-852-8641
Mailing Address - Street 1:20 MORNING GLORY CT
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2485
Mailing Address - Country:US
Mailing Address - Phone:541-852-8641
Mailing Address - Fax:
Practice Address - Street 1:20 MORNING GLORY CT
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2485
Practice Address - Country:US
Practice Address - Phone:541-852-8641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty