Metamorphosis Counseling And Health Center Of Idaho, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Boise, ID. Organization (NPI-2).
NPI number1235791997
StatusActive
Last updated in NPPESOct 7, 2026
Details
- NPI
- 1235791997
- Entity type
- Organization (NPI-2)
- Legal business name
- Metamorphosis Counseling And Health Center Of Idaho, LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 2, 2019
- Certification date
- Oct 7, 2026
- Last updated
- Oct 7, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 101YP2500X | Counselor, Professional | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 172V00000X | Community Health Worker | – | – | |
| 175T00000X | Peer Specialist | – | – | |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
10108 W Overland Rd # ABoise, ID 83709-1428
Phone 208-376-1532 · Fax 208-375-7251
Mailing address
10108 W Overland Rd # ABoise, ID 83709-1428
Phone 208-376-1532 · Fax 208-375-7251
Authorized official
Crystal Michelle Miller
Executive Director/Owner
2083761532
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