Amethyst Behavioral Health, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

AMETHYST BEHAVIORAL HEALTH, LLC

Practice address

921 Tribune St
Redlands, CA 92374-3422

Phone

(909) 809-7671

NPI assigned

Mar 3, 2021

Last updated

Sep 25, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cole Oliver Fry

Title

Ceo

Phone

(909) 809-7671

Specialties & licenses 2

Addresses

Tax ID family

Amethyst Behavioral Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amethyst Behavioral Health, LLC

  • Clinical Social Worker
  • Redlands, CA
  • NPI 1740113299
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Amethyst Behavioral Health, LLC

  • Clinical Social Worker
  • Redlands, CA
  • NPI 1740113299
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary M Entezar

  • Marriage & Family Therapist
  • Redlands, CA
  • NPI 1225297195
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1134714033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E UNION AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743332",
            "telephone_number": "909-809-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 TRIBUNE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743422",
            "telephone_number": "909-809-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 Hartzell Ave",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923742409",
            "country_code": "US",
            "telephone_number": "909-809-9293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 Tribune St",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923743422",
            "country_code": "US",
            "telephone_number": "909-809-9293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "923 Tribune St",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923743422",
            "country_code": "US",
            "telephone_number": "909-809-9293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMETHYST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "COLE",
        "authorized_official_middle_name": "OLIVER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-809-7671"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.