# PRISM PSYCHOTHERAPY LCSW PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619479961
- **Authorized official:** MARY E. PACOS LCSWR (OWNER)
- **Authorized official phone:** (845) 656-2606

## Contact information

- **Practice address:** 56 MAIN ST STE 3-5, WARWICK, NY 10990-1345
- **Practice address phone:** (845) 656-2606
- **Mailing address:** PO BOX 1196, WARWICK, NY 10990-8196
- **Mailing address phone:** (845) 656-2606
- **Mailing address fax:** (205) 827-8045

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2018
- **Last updated:** 10/14/2025