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NPI Code Detail

MEDICARE: PRISM MENTAL HEALTH PLLC

MEDICARE: PRISM MENTAL HEALTH PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1053110577
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRISM MENTAL HEALTH PLLC
Provider Business Mailing Address
First Line : 5335 W 48TH AVE STE 500
Second Line :
City : DENVER
State : CO
Zip : 80212-2732
Country : US
Telephone Number : 303-351-2173
Fax Number :
Provider Business Practice Location Address
First Line : 5335 W 48TH AVE STE 500
Second Line :
City : DENVER
State : CO
Zip : 80212-2732
Country : US
Telephone Number : 303-351-2173
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : SAMANTHA JOHNSON
Credential : MSN, FNP-C, PMHP-BC
Telephone Number : 303-351-2173
Provider Enumeration Date : 03/08/2025
Last Update Date : 04/08/2026

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Directions to “PRISM MENTAL HEALTH PLLC ” Practice Location

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