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Contact Information

PRISMA WISCONSIN LLC
13500 WATERTOWN PLANK RD STE 102
ELM GROVE, WI53122-2222
 Phone: 206-785-1015
 Fax: 206-785-1023
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychiatric/Mental Health, Adult

364SP0809X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for PRISMA WISCONSIN LLC

NPI Number 1497519979
LBN Legal business name PRISMA WISCONSIN LLC
Authorized official SCOTT WIENER - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2024
Last updated 02/06/2024 - About 2 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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