Prism Psych, PLLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Vancleave, MS
NPI 1154043495 · NPPES record last updated Sep 14, 2022
Key facts
- NPI
- 1154043495
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- PRISM PSYCH, PLLC
- Practice address
- 2817 Blackfoot Rd
Vancleave, MS 39565-8321 - Phone
- (423) 748-2966
- Fax
- (615) 247-6510
- NPI assigned
- Sep 14, 2022
- Organization subpart
- No
Authorized official
- Name
- Dr. Latoya R Favre, PHD
- Title
- Licensed Psychologist
- Phone
- (423) 748-2966
Practitioners 1
-
Latoya Favre, PHD, HSP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
2817 Blackfoot Rd
Vancleave, MS 39565-8321
Mailing address
2817 Blackfoot Rd
Vancleave, MS 39565-8321
Phone (423) 748-2966
Other names
- Prism Psych, PLLC
Other providers in Vancleave, MS
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- Clarissa Picard
- Melissa Ann Ranson
- Karen Petra Reynolds
- Katherine Sloop Roberts
- Jayme Robinson
- Charlene Russell
All providers in Vancleave, MS · Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.