Provider Demographics
NPI:1437978731
Name:TRANSFORMATIVE COUNSELING & CONSULTATION LLC
Entity type:Organization
Organization Name:TRANSFORMATIVE COUNSELING & CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:VITKUN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-291-8935
Mailing Address - Street 1:133 RESERVE CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8484
Mailing Address - Country:US
Mailing Address - Phone:321-291-8935
Mailing Address - Fax:
Practice Address - Street 1:133 RESERVE CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8484
Practice Address - Country:US
Practice Address - Phone:321-291-8935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty