Provider Demographics
NPI:1699435230
Name:ELEVATION COUNSELING AND CONSULTING LLC
Entity type:Organization
Organization Name:ELEVATION COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:623-606-5522
Mailing Address - Street 1:7558 W THUNDERBIRD RD STE 1-492
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-6080
Mailing Address - Country:US
Mailing Address - Phone:623-606-5522
Mailing Address - Fax:623-878-5800
Practice Address - Street 1:17505 N 79TH AVE STE 304A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8729
Practice Address - Country:US
Practice Address - Phone:623-606-5522
Practice Address - Fax:623-878-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty