MEDICARE: ALCHEMY WITHIN, COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1316730138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALCHEMY WITHIN, COUNSELING LLC

Provider Business Mailing Address
First Line	:	9300 SPRUCE MOUNTAIN WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6016
Country	:	US
Telephone Number	:	623-703-4754
Fax Number	:

Provider Business Practice Location Address
First Line	:	9300 SPRUCE MOUNTAIN WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6016
Country	:	US
Telephone Number	:	623-703-4754
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	COURTNEY B JORDAN
Credential	:	LCSW
Telephone Number	:	702-608-4965

Provider Enumeration Date	:	05/24/2025
Last Update Date	:	05/24/2025

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