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Organization

PRISMA WELLNESS, PLLC

Active
Parent organization
PRISMA WELLNESS, PLLC
Other names
Prisma Wellness, PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PRISMA WELLNESS, PLLC
Authorized official
DR. SCOTT WIENER MD (CHIEF MEDICAL OFFICER)
(206) 785-1015
Entity
Organization

Contact information

Practice address
13500 WATERTOWN PLANK RD STE 102, ELM GROVE, WI 53122-2222
(206) 785-1015
(206) 785-1023
Mailing address
2031 RIDGE END RD, VIRGINIA BEACH, VA 23454-1028
(206) 939-1456
(206) 785-1023

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
03/17/2022
Last updated
03/17/2022
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