Organization
PRISMA COMMUNITY CARE
Active
Other names
Southwest Center
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY SIMON (AUTHORIZED OFFICIAL)
(602) 307-5330
Entity
Organization
Contact information
Practice address
1101 N. CENTRAL AVENUE, SUITE 200, PHOENIX, AZ 85004
(602) 307-5330
(602) 307-5021
Mailing address
1101 N CENTRAL AVE STE 200, PHOENIX, AZ 85004-1844
(602) 347-0873
(602) 246-1980
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
163W00000X
Registered Nurse
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
928418
—
AZ
Enumeration date
09/07/2006
Last updated
09/02/2025
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