Healthcare Provider Details

I. General information

NPI: 1124932389
Provider Name (Legal Business Name): TRANSFORMATION HEALTH SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CADMAN PLZ W
BROOKLYN NY
11201-3229
US

IV. Provider business mailing address

300 CADMAN PLZ W
BROOKLYN NY
11201-3229
US

V. Phone/Fax

Practice location:
  • Phone: 718-532-3011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARCELLI PASCAL-RODRIGUEZ
Title or Position: CEO
Credential: PMHNP-BC
Phone: 757-490-6463