PRIZM BEHAVIORAL SERVICES PC NPI 1306007778

NPI Information

NPI: 1306007778
Provider Name: PRIZM BEHAVIORAL SERVICES, PC
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
1112 S WASHINGTON ST
SUITE 202
NAPERVILLE, IL
ZIP 60540
Phone: (630) 848-1200
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PRIZM BEHAVIORAL SERVICES, PC is an adolescent and children mental health clinic center in Naperville, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. PRIZM BEHAVIORAL SERVICES, PC NPI is 1306007778. The provider is registered as an organization entity type.

The provider's business location address is:

1112 S WASHINGTON ST
SUITE 202
NAPERVILLE, IL
ZIP 60540-959
Phone: (630) 848-1200
Fax: (630) 848-1208

The provider's authorized official is Asmat Z Jafry .
The authorized official title is Psychiatrist and has the following contact phone number (630) 848-1200.

The enumeration date for this NPI number is 6/18/2008 and was last updated on 11/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	305R00000X	Preferred Provider Organization		036114959	ILLINOIS	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	036114959	ILLINOIS	No
3	261QM0850X	Clinic/Center	Adult Mental Health	036114959	ILLINOIS	No
4	261QM2500X	Clinic/Center	Medical Specialty	036114959	ILLINOIS	No
5	261Q00000X	Clinic/Center		036114959	ILLINOIS	No
6	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	036114959	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	I60233	MEDICARE UPIN	ILLINOIS
2	036114959	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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