=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386514073
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLLABORATIVE TRANSFORMATION - LCSW, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2025
-----------------------------------------------------
Last Update Date | 11/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3171 WHITNEY AVE APT 3D
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11229-5900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-754-7533
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3171 WHITNEY AVE APT 3D
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11229-5900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-754-7533
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | MR. LYLE LAURENCE SCHMERZ
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 917-754-7533
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------