Prism Health and Wellness LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

PRISM HEALTH AND WELLNESS LLC

Practice address

933 Erie Ave Ste 2
Sheboygan, WI 53081-3300

Phone

(920) 254-1684

NPI assigned

Oct 4, 2022

Last updated

Oct 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ka Vang LeeNPI 1285090936

Title

Owner

Phone

(920) 287-5946

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ka V Lee, LPC

  • Professional Counselor
  • Sheboygan, WI
  • NPI 1285090936
  Medicare reassignment NPD Authorized official
• Rachael Sass, LPC

  • Professional Counselor
  • Sheboygan, WI
  • NPI 1861007098
  Medicare reassignment NPD
• Tao Lee, NP

  • Adult Health Nurse Practitioner
  • Cleveland, WI
  • NPI 1295060275
  NPD (past)

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1871218636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 N 26TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834479",
            "telephone_number": "920-287-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 ERIE AVE STE 2",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813300",
            "telephone_number": "920-254-1684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 N 26th St",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530834479",
            "country_code": "US",
            "telephone_number": "920-287-5946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRISM HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KA",
        "authorized_official_middle_name": "VANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-287-5946"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela R Portschy, M.D.
• Terri Preston, CPHT
• Prevea (Prevea Sheboygan)
• Allyson Elizabeth Pribbernow, OTR
• Jeff Prill, PHARMD
• Progressive Beginnings, LLC
• Jenna K Provance, PA-C
• Thomas Allen Puffett, MD
• Sree Ramya Punukollu
• Marissa Purdoff, MS, LAT

• Professional Counselor in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.