| Prism Health And Wellness Llc | |
|
933 Erie Ave Ste 2 Sheboygan WI 53081-3300 | |
| (920) 254-1684 | |
| Not Available |
| Full Name | Prism Health And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 933 Erie Ave Ste 2, Sheboygan, Wisconsin |
| Authorized Official Name and Position | Ka Vang Lee (OWNER) |
| Authorized Official Contact | 9202875946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Health And Wellness Llc 2401 N 26th St Sheboygan WI 53083-4479 Ph: (920) 287-5946 | Prism Health And Wellness Llc 933 Erie Ave Ste 2 Sheboygan WI 53081-3300 Ph: (920) 254-1684 |
| NPI Number | 1871218636 |
|---|---|
| Provider Enumeration Date | 10/04/2022 |
| Last Update Date | 10/11/2022 |
| Certification Date | 10/11/2022 |
| Medicare PECOS PAC ID | 4981138732 |
|---|---|
| Medicare Enrollment ID | O20241115001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871218636 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Ka Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285090936 PECOS PAC ID: 5496289258 Enrollment ID: I20241115001617 |
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