| Prism Psych, Pllc | |
|
2817 Blackfoot Rd Vancleave MS 39565-8321 | |
| (423) 748-2966 | |
| (615) 247-6510 |
| Full Name | Prism Psych, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2817 Blackfoot Rd, Vancleave, Mississippi |
| Authorized Official Name and Position | Latoya R Favre (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4237482966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Psych, Pllc 2817 Blackfoot Rd Vancleave MS 39565-8321 Ph: (423) 748-2966 | Prism Psych, Pllc 2817 Blackfoot Rd Vancleave MS 39565-8321 Ph: (423) 748-2966 |
| NPI Number | 1154043495 |
|---|---|
| Provider Enumeration Date | 09/14/2022 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154043495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Home Of Grace Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14200 Jericho Rd, Vancleave, MS 39565 Phone: 228-826-5283 Fax: 228-826-1663 | |
Triple H Ranch Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7205 Humphrey Rd, Vancleave, MS 39565 Phone: 228-283-5005 |