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General NPI Number Information
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NPI Number | 1144079757
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Entity Type | Organization
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Legal Business Name | PRISM MENTAL HEALTH SOLUTIONS INC
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | PRISM MENTAL HEALTH SOLUTIONS INC 264 HAIDA AVE, SUITE B1
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City | HASTINGS
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State | PA
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Zip | 16646-5611
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Country | US
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Telephone | 814-515-3427
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Fax |
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Provider Business Mailing Address
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Address Line | 264 HAIDA AVENUE SUITE B1
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City | HASTINGS
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State | PA
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Zip | 16646
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Country | US
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Telephone | 814-931-0417
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | MRS. CHELSEA LYNN WADE
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Credential | LCSW
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Telephone | 814-931-0417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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