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General NPI Number Information
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NPI Number | 1285135012
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Entity Type | Organization
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Legal Business Name | PRISM COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 36 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3440
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Country | US
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Telephone | 973-355-7115
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Fax |
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Provider Business Mailing Address
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Address Line | 36 PARK ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3440
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Country | US
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Telephone | 973-355-7115
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SHAE CALI
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Credential | LCSW
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Telephone | 973-355-7115
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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 | 44SC05770400
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License Number State | NJ
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