NPIMap

Organization Active NPI

Prism Counseling LLC

  • Pastoral Counselor
  • Peoria, AZ
National Provider Identifier
1104459809
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
Legal business name
PRISM COUNSELING LLC
Practice address
9299 W Olive Ave Ste 212
Peoria, AZ 85345-8382
Phone
(480) 525-7284
NPI assigned
Feb 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tres Manuel Adames, MDIV, BCPCNPI 1215320890
Title
Director
Phone
(480) 525-7284

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

9299 W Olive Ave Ste 212
Peoria, AZ 85345-8382

Mailing address

9299 W Olive Ave Ste 212
Peoria, AZ 85345-8382
Phone (480) 525-7284

National Provider Directory

National Provider Directory

Locations

9299 W Olive Ave
Ste 212
Peoria, AZ 85345
Phone (480) 525-7284

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1104459809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9299 W OLIVE AVE STE 212",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458382",
            "telephone_number": "480-525-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9299 W OLIVE AVE STE 212",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458382",
            "telephone_number": "480-525-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "ADAMES",
        "authorized_official_first_name": "TRES",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-525-7284",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MDIV, BCPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.