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Organization
TRANSFORMATIVE VISION
Active
Organization
TRANSFORMATIVE VISION
Active
Parent organization
TRANSFORMATIVE VISION PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRANSFORMATIVE VISION PLLC
Authorized official
JACQUELINE BUSH LMFT, BC-TMH (CLINICAL DIRECTOR)
(704) 879-1179
Entity
Organization
Contact information
Practice address
227 W 4TH ST STE 321, CHARLOTTE, NC 28202-1545
(704) 879-1179
Mailing address
PO BOX 82406, BATON ROUGE, LA 70884-2406
(704) 879-1179
(704) 490-4274
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
03/04/2026
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