Provider Demographics
NPI:1760270581
Name:LIFE TRANSFORMATION THERAPY PLLC
Entity type:Organization
Organization Name:LIFE TRANSFORMATION THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-CARDOSO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:509-366-1484
Mailing Address - Street 1:819 S AUBURN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-9998
Mailing Address - Country:US
Mailing Address - Phone:509-366-1484
Mailing Address - Fax:509-231-8400
Practice Address - Street 1:819 S AUBURN ST
Practice Address - Street 2:SUITE B
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-9998
Practice Address - Country:US
Practice Address - Phone:509-366-1484
Practice Address - Fax:509-231-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty