Provider Demographics
NPI:1154007540
Name:PRISM COUNSELING
Entity type:Organization
Organization Name:PRISM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZONI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:912-631-7241
Mailing Address - Street 1:4656 SYLVAN DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5132
Mailing Address - Country:US
Mailing Address - Phone:912-631-7241
Mailing Address - Fax:912-202-1003
Practice Address - Street 1:3025 BULL ST STE 227
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2016
Practice Address - Country:US
Practice Address - Phone:912-272-7536
Practice Address - Fax:912-202-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)