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General NPI Number Information
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NPI Number | 1932817350
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Entity Type | Organization
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Legal Business Name | PRISMATIC APPROACH THERAPY & WELLNESS, LLC
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 3883 NORMAL BLVD STE 204
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City | LINCOLN
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State | NE
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Zip | 68506-5218
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Country | US
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Telephone | 402-218-1824
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 S 34TH ST
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City | LINCOLN
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State | NE
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Zip | 68506-3210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | AMY VANDERPOOL
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Credential | LIMHP
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Telephone | 402-218-1824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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