Organization
AMETHYST COUNSELING AND CASE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JAMILA GILLIAM LMSW (OWNER)
(907) 302-8366
Entity
Organization
Contact information
Practice address
3400 E RIVER VALLEY ST APT J202, MERIDIAN, ID 83646-2361
(907) 302-8366
Mailing address
3400 E RIVER VALLEY ST APT J202, MERIDIAN, ID 83646-2361
(907) 302-8366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
163WC0400X
Case Management Registered Nurse
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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