Organization
A TRANSFORMING LIFE WELLNESS CTR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN RICHARDSON LPCC (CEO)
(216) 702-8526
Entity
Organization
Contact information
Practice address
781 BETA DR, SUITE K1, MAYFIELD VILLAGE, OH 44143-2356
(440) 565-7833
(440) 684-9030
Mailing address
7085 W 130TH ST, #201A, PARMA HEIGHTS, OH 44130-7851
(440) 565-7833
(440) 684-9030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0500069
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
896347
—
OH
Enumeration date
03/07/2017
Last updated
03/07/2017
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