| Prism Counseling Services, Llc | |
|
3009 E 4th St Austin TX 78702-4811 | |
| (419) 706-8726 | |
| Not Available |
| Full Name | Prism Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 3009 E 4th St, Austin, Texas |
| Authorized Official Name and Position | Miranda Sue Casero (OWNER) |
| Authorized Official Contact | 5128431451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Counseling Services, Llc 3009 E. 4th St. Austin TX 78702 Ph: (419) 706-8726 | Prism Counseling Services, Llc 3009 E 4th St Austin TX 78702-4811 Ph: (419) 706-8726 |
| NPI Number | 1568905768 |
|---|---|
| Provider Enumeration Date | 11/21/2016 |
| Last Update Date | 08/19/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 6305235268 |
|---|---|
| Medicare Enrollment ID | O20211115001492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568905768 | NPI | - | NPPES |
| Provider Name | Ryan L Kjome |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245486323 PECOS PAC ID: 0547326654 Enrollment ID: I20090225000359 |
| Provider Name | Mallie D Underwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447716246 PECOS PAC ID: 4385986926 Enrollment ID: I20190430002041 |
| Provider Name | Miranda Casero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700335015 PECOS PAC ID: 7012306988 Enrollment ID: I20211115001947 |
| Provider Name | Natalie Skipworth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932501723 PECOS PAC ID: 5799158135 Enrollment ID: I20230306000322 |
| Provider Name | Lita B Hickey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881352961 PECOS PAC ID: 0547635997 Enrollment ID: I20230417001972 |
| Provider Name | Ana Maria Cubilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124537238 PECOS PAC ID: 5597116012 Enrollment ID: I20240410002740 |
| Provider Name | Rebecca Laufe Scheer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154910305 PECOS PAC ID: 9830631787 Enrollment ID: I20240606001395 |
| Provider Name | Kabir Advik Parikh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649084187 PECOS PAC ID: 2769903848 Enrollment ID: I20250305002060 |
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