Healthcare Provider Details

I. General information

NPI: 1508017658
Provider Name (Legal Business Name): JOAN ELLEN PRESCOTT RN, PMHCNS-BC, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 01/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S LANCASTER RD MENTAL HEALTH (116A)
DALLAS TX
75216-7167
US

IV. Provider business mailing address

2804 AMHERST AVE
DALLAS TX
75225-7903
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-1004
  • Fax:
Mailing address:
  • Phone: 214-226-5489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number598523
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: