Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Transformation Station LLC

Organization Child & Adolescent Psychiatric/Mental Health Registered Nurse · NPI 1386370757

Transformation Station LLC is a Child & Adolescent Psychiatric/Mental Health Registered Nurse in Baltimore, Maryland. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4200 Edmondson Ave Ste 100
Baltimore, MD 21229-1617
Phone: (443) 873-8139
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
Child & Adolescent Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0807X

Record details

NPI number1386370757
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Darryl Moody — Owner · (443) 310-2572
NPI enumeratedJuly 28, 2022
Last updated in NPPESAugust 18, 2023
Certification dateAugust 18, 2023
Mailing address4200 Edmondson Ave Ste 100, Baltimore, MD 21229-1617

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