Provider Demographics
NPI:1184336307
Name:HEART ALCHEMY LLC
Entity type:Organization
Organization Name:HEART ALCHEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JULI
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:208-402-8166
Mailing Address - Street 1:4092 S MILL SITE AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-8637
Mailing Address - Country:US
Mailing Address - Phone:208-991-7782
Mailing Address - Fax:
Practice Address - Street 1:750 E WARM SPRINGS AVE STE D2
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6475
Practice Address - Country:US
Practice Address - Phone:208-402-8166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health