Provider Demographics
NPI:1689329468
Name:AMETHYST GROWTH & COUNSELING SERVICES
Entity Type:Organization
Organization Name:AMETHYST GROWTH & COUNSELING SERVICES
Other - Org Name:AMETHYST PERSONAL GROWTH & COUNSELING SERVICES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAJAKTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-704-5383
Mailing Address - Street 1:5 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1677
Mailing Address - Country:US
Mailing Address - Phone:609-704-5384
Mailing Address - Fax:
Practice Address - Street 1:5 S 3RD ST
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1677
Practice Address - Country:US
Practice Address - Phone:609-704-5384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1689329468OtherNPI
NJ1659520559OtherNPI
NJ1790879088OtherNPI
NJ1932123122OtherNPI
NJ1174033252OtherNPI
NJ1770032237OtherNPI