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Transformation Mental Health Therapy, PLLC

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Company Details

Name: Transformation Mental Health Therapy, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 19 Sep 2023 (2 years ago)
Financial Date End: 30 Sep 2025
Entity Number: 5405917
Place of Formation: IDAHO
File Number: 899023
ZIP code: 83835
County: Kootenai County
Principal Address: KIMBERLY SHELDEN 843 PLACER CT HAYDEN, ID 83835
Mailing Address: KIMBERLY SHELDEN 843 PLACER CT HAYDEN, ID 83835-8731

Agent

Name Role Address
George I May Agent 843 PLACER CT, HAYDEN, ID 83835

Manager

Name Role Address Appointed On
Kimberly L Shelden Manager 843 PLACER CT, HAYDEN, ID 83835 2024-10-14

National Provider Identifier

NPI Number:
1033996236
Certification Date:
2023-09-17

Authorized Person:

Name:
KIMBERLY LYNN SHELDEN
Role:
OWNER/THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
8888922509

Filing

Filing Name Filing Number Filing date
Annual Report 0005940656 2024-10-14
Initial Filing 0005405917 2023-09-19

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Date of last update: 11 Jul 2025

Sources: Idaho Secretary of State