# AMETHYST CENTER FOR HEALING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194198010
- **Authorized official:** JANA CLAIRE FULMER LPC (CO-FOUNDER/CO-DIRECTOR)
- **Authorized official phone:** (435) 640-7466

## Contact information

- **Practice address:** 124 S 400 E STE 300, SALT LAKE CITY, UT 84111-5307
- **Practice address phone:** (801) 467-2863
- **Mailing address:** PO BOX 526391, SALT LAKE CITY, UT 84152-6391
- **Mailing address phone:** (801) 467-2863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 11/02/2015
- **Last updated:** 07/08/2021