NPIMap

Organization Active NPI

Amethyst Center for Healing

  • Mental Health Counselor
  • Salt Lake City, UT
National Provider Identifier
1194198010
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
AMETHYST CENTER FOR HEALING
Practice address
124 S 400 E Ste 300
Salt Lake City, UT 84111-5307
Phone
(801) 467-2863
NPI assigned
Nov 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Jana Claire Fulmer, LPCNPI 1699077461
Title
Co-Founder/Co-Director
Phone
(435) 640-7466

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

124 S 400 E Ste 300
Salt Lake City, UT 84111-5307

Mailing address

PO Box 526391
Salt Lake City, UT 84152-6391
Phone (801) 467-2863

National Provider Directory

National Provider Directory
Tax ID family
Amethyst Center for Healing2 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.

Locations

1104 E Ashton Ave
Ste 212
Salt Lake City, UT 84106
Phone (435) 730-2973

Practitioners & affiliated clinicians

Practitioners 8

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": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1194198010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526391",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841526391",
            "telephone_number": "801-467-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S 400 E STE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841115307",
            "telephone_number": "801-467-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMETHYST CENTER FOR HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "CO-FOUNDER/CO-DIRECTOR",
        "authorized_official_telephone_number": "435-640-7466",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.