Prism Family Counseling Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

MFT 42219 Issued in CA

Legal business name

PRISM FAMILY COUNSELING INC

Practice address

206 Avocado Ave. Suite 103
Perris, CA 92571

Phone

(951) 206-7545

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Carmelo Isales, PSY.DNPI 1477722726

Title

Ceo

Phone

(951) 206-7545

Specialties & licenses 2

Addresses

Practitioners 1

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

• Carmelo Isales Jr., PSY.D LMFT

  • Marriage & Family Therapist
  • Murrieta, CA
  • NPI 1477722726
  NPD (past) Authorized official

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1821549981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29384 MASTERS DR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925635855",
            "telephone_number": "951-206-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 AVOCADO AVE. SUITE 103",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "92571",
            "telephone_number": "951-206-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM FAMILY COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "ISALES",
        "authorized_official_first_name": "CARMELO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-206-7545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "LCS 11045",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "MFT 42219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Perris, CA
• Providers in Perris, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.