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Organization
TRANSFORMATIVE VISION PLLC
Active
Organization
TRANSFORMATIVE VISION PLLC
Active
Other names
TRANSFORMATIVE VISION THERAPY COLLECTIVE, TRANSFORMATIVE VISION WELLNESS CENTER, TRANSFORMATIVE VISION
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE BUSH LMFT, BC-TMH (CLINICIAL DIRECTOR)
(704) 879-1179
Entity
Organization
Contact information
Practice address
227 W 4TH ST STE 321, CHARLOTTE, NC 28202-1545
(704) 879-1179
(704) 490-4274
Mailing address
PO BOX 82406, BATON ROUGE, LA 70884-2406
(704) 879-1179
(704) 490-4274
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
05/12/2020
Last updated
03/04/2026
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