NPIMap

Organization Active NPI

Ultreia Enlightened Transitions, LLC

  • Social Worker
  • Boise, ID
National Provider Identifier
1134798341
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
ULTREIA ENLIGHTENED TRANSITIONS, LLC
Practice address
6322 W Robertson Dr
Boise, ID 83709-2173
Phone
(208) 571-9709
NPI assigned
Jun 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Heather Mosqueda Crist, LMSWNPI 1518588375
Title
Owner
Phone
(208) 571-9709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

6322 W Robertson Dr
Boise, ID 83709-2173

Mailing address

6322 W Robertson Dr
Boise, ID 83709-2173
Phone (208) 571-9709

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1134798341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 W ROBERTSON DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092173",
            "telephone_number": "208-571-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 W ROBERTSON DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092173",
            "telephone_number": "208-571-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTREIA ENLIGHTENED TRANSITIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "CRIST",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MOSQUEDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-571-9709",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.