Provider Demographics
NPI:1063967123
Name:TRANSITIONS COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:TRANSITIONS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL CLINICAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:937-271-3645
Mailing Address - Street 1:229 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-4609
Mailing Address - Country:US
Mailing Address - Phone:937-232-6007
Mailing Address - Fax:
Practice Address - Street 1:475 ARLINGTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-1110
Practice Address - Country:US
Practice Address - Phone:937-271-3645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0600039-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty