Provider Demographics
NPI:1285135012
Name:PRISM COUNSELING AND CONSULTING
Entity type:Organization
Organization Name:PRISM COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-355-7115
Mailing Address - Street 1:36 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3440
Mailing Address - Country:US
Mailing Address - Phone:973-355-7115
Mailing Address - Fax:
Practice Address - Street 1:36 PARK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3440
Practice Address - Country:US
Practice Address - Phone:973-355-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057704001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty