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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