Provider Demographics
NPI:1881068500
Name:AMETHYST CONSULTING & TREATMENT SOLUTIONS, PLLC
Entity type:Organization
Organization Name:AMETHYST CONSULTING & TREATMENT SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:336-674-9781
Mailing Address - Street 1:3908 FOX GROVE TRL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-9375
Mailing Address - Country:US
Mailing Address - Phone:336-674-9781
Mailing Address - Fax:336-282-3430
Practice Address - Street 1:101 N CARTER ST
Practice Address - Street 2:SUITE 9
Practice Address - City:LA CROSSE
Practice Address - State:VA
Practice Address - Zip Code:23950-1900
Practice Address - Country:US
Practice Address - Phone:336-674-9781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMETHYST CONSULTING & TREATMENT SOLUTIONS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-18
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904009132OtherLCSW LICENSE NUMBER