MEDICARE: ETHOS PRISM, LLC

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1932761897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETHOS PRISM, LLC

Provider Business Mailing Address
First Line	:	5757 WOODWAY DR STE 285
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-1533
Country	:	US
Telephone Number	:	713-324-3754
Fax Number	:	713-324-3754

Provider Business Practice Location Address
First Line	:	5757 WOODWAY DR STE 285
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-1533
Country	:	US
Telephone Number	:	713-324-3754
Fax Number	:	713-324-3754

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. LISA FRANKS
Credential	:	LCSW
Telephone Number	:	713-574-8172

Provider Enumeration Date	:	07/01/2019
Last Update Date	:	01/15/2026

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