Provider Demographics
NPI:1295623080
Name:ELEVATION THERAPY LLC
Entity type:Organization
Organization Name:ELEVATION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:KAELIN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-222-7704
Mailing Address - Street 1:330 S SECOND AVE SUITE 200 #1151
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2289
Mailing Address - Country:US
Mailing Address - Phone:952-222-7704
Mailing Address - Fax:
Practice Address - Street 1:12400 PORTLAND AVE STE 180
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6875
Practice Address - Country:US
Practice Address - Phone:952-222-7704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty