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General NPI Number Information
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NPI Number | 1821916289
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Entity Type | Organization
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Legal Business Name | AMETHYST HOLISTIC COUNSELING, A PROFESSIONAL CLINICAL COUNSELOR CORP.
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 5952 TROJAN AVE
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City | SAN DIEGO
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State | CA
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Zip | 92115-5406
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Country | US
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Telephone | 619-259-0744
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 UNIVERSITY AVE STE E107 #707
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City | SAN DIEGO
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State | CA
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Zip | 92103-3359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEA M ROMAN
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Credential | LPCC
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Telephone | 214-789-9025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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