Prism Integrative Health, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PRISM INTEGRATIVE HEALTH, LLC

Practice address

8030 Woodmont Ave FL 3
Bethesda, MD 20814-3027

Phone

(301) 651-0303

NPI assigned

Jun 17, 2020

Last updated

Jun 18, 2020By 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

Sasha Bergeron, NP

Title

Co-Founder

Phone

(202) 213-4829

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1891311718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 WOODMONT AVE FL 3",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143027",
            "telephone_number": "202-213-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 WOODMONT AVE FL 3",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143027",
            "telephone_number": "301-651-0303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4108 Ingomar St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200151946",
            "country_code": "US",
            "telephone_number": "202-213-4829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRISM INTEGRATIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "SASHA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "202-213-4829",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Lynn Priboth, R.D.
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• Mental Health Counselor in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Mental Health Counselor in Maryland

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