Provider Demographics
NPI:1730953324
Name:PRISM WELLNESS SOLUTIONS LLC
Entity type:Organization
Organization Name:PRISM WELLNESS SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP / CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOYT
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:859-494-9984
Mailing Address - Street 1:989 GOVERNORS LN STE 140
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1174
Mailing Address - Country:US
Mailing Address - Phone:859-494-9984
Mailing Address - Fax:833-973-4422
Practice Address - Street 1:989 GOVERNORS LN STE 140
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1174
Practice Address - Country:US
Practice Address - Phone:859-494-9984
Practice Address - Fax:859-484-7186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty