Organization
PRISM THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA M PLADSEN LMFT (OWNER)
(319) 361-9381
Entity
Organization
Contact information
Practice address
1089 LONGFELLOW DR STE C, HIAWATHA, IA 52233-2032
(319) 361-9381
Mailing address
2886 61ST STREET LN LOT 4, VINTON, IA 52349-9265
(319) 361-9381
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609919358
—
IA
Enumeration date
06/13/2021
Last updated
07/26/2021
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