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TRANSFORMATIVE WELLNESS, INC
NPI 1528703014
Psychologist - Clinical in Chicago, IL

Active since April 29, 2022
611 W BRIAR PL STE 6, CHICAGO, IL 60657(312) 375-5621 Get Directions Write a Review

NPPES record last updated: May 25, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: May 25, 2022, Apr 29, 2022 (2 updates tracked since 2022).

About Transformative Wellness, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRANSFORMATIVE WELLNESS, INC (NPI 1528703014) is a healthcare organization registered as a clinical in Chicago, Illinois and active in the NPI registry since April 2022. The organization lists Maudette M Jackson, President/clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1528703014
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameTRANSFORMATIVE WELLNESS, INC
Location Address611 W BRIAR PL STE 6Chicago, IL 60657-4560
Mailing Address7725 S Crandon AveChicago, IL 60649-4118 · (312) 375-5621
Phone(312) 375-5621
Organization SubpartNo
Authorized OfficialMaudette M JacksonPresident/clinical Psychologist · (312) 375-5621
Enumeration DateApril 29, 2022
Last NPPES UpdateMay 25, 20222 updates tracked since enumeration
NPPES CertifiedMay 25, 2022
✔ NPI 1528703014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
611 W BRIAR PL STE 6, Chicago, IL 60657
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PIVOT BEHAVIORAL HEALTH, PLLC
Psychologist (Health)
611 W BRIAR PL STE 6
CHICAGO, IL 60657
Cook County (773) 234-1721
EMERSON M. EPSTEIN PHD
Psychologist (Clinical)
611 W BRIAR PL STE 6
CHICAGO, IL 60657
Cook County (773) 234-1721

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Transformative Wellness, Inc's NPI number?

The NPI number for Transformative Wellness, Inc is 1528703014. It was assigned to this organization in the NPPES registry on April 29, 2022.

Where is Transformative Wellness, Inc located?

Transformative Wellness, Inc is located at 611 W Briar Pl Ste 6, Chicago, IL 60657. The listed phone number is (312) 375-5621.

What is Transformative Wellness, Inc's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Transformative Wellness, Inc was last updated on May 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.