Provider Demographics
NPI:1578029542
Name:PRISM BEHAVIORAL CONSULTING LLC
Entity Type:Organization
Organization Name:PRISM BEHAVIORAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, BCBA
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-467-9094
Mailing Address - Street 1:23007 66TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2405
Mailing Address - Country:US
Mailing Address - Phone:480-467-9094
Mailing Address - Fax:
Practice Address - Street 1:23007 66TH AVE W
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2405
Practice Address - Country:US
Practice Address - Phone:480-467-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty