Prism Creative Arts Wellness Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PRISM CREATIVE ARTS WELLNESS CENTER LLC

Practice address

4441 Rice St Unit 662112
Lihue, HI 96766-7605

Phone

(720) 541-9007

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Jie ShenNPI 1306476601

Title

Owner

Phone

(310) 993-2017

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jie Shen

  • Mental Health Counselor
  • Lihue, HI
  • NPI 1306476601
  NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1255119780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662112",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967667112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 RICE ST UNIT 662112",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967667605",
            "telephone_number": "720-541-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM CREATIVE ARTS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-16",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "JIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-993-2017"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Lihue, HI
• Providers in Lihue, HI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.