NPIMap

Organization Active NPI

Metamorphosis Counseling and Health Center of Idaho, LLC

  • Peer Specialist
  • Boise, ID
National Provider Identifier
1760286330
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
METAMORPHOSIS COUNSELING AND HEALTH CENTER OF IDAHO, LLC
Practice address
10108 W Overland Rd # a
Boise, ID 83709-1428
Phone
(208) 376-1532
Fax
(208) 375-7251
NPI assigned
Apr 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Mrs. Crystal Michelle Miller
Title
Executive Director and Owner
Phone
(208) 890-6205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

10108 W Overland Rd # a
Boise, ID 83709-1428

Mailing address

10108 W Overland Rd # a
Boise, ID 83709-1428
Phone (208) 376-1532

National Provider Directory

National Provider Directory
Tax ID family
Metamorphosis Counseling and Health Center of Idaho LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

10108 W Overland Rd
#A
Boise, ID 83709
Phone (208) 376-1532

NPI Registry JSON

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1760286330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10108 W OVERLAND RD # A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-376-1532",
            "fax_number": "208-375-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10108 W OVERLAND RD # A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-376-1532",
            "fax_number": "208-375-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS COUNSELING AND HEALTH CENTER OF IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR AND OWNER",
        "authorized_official_telephone_number": "208-890-6205",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "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 Apr 2, 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.