Provider Demographics
NPI:1083179196
Name:ELEVATE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ELEVATE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KASSIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUNN-WEILAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCSW
Authorized Official - Phone:734-274-9922
Mailing Address - Street 1:2737 HOLYOKE LN
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2202
Mailing Address - Country:US
Mailing Address - Phone:734-274-9922
Mailing Address - Fax:
Practice Address - Street 1:2737 HOLYOKE LN
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2202
Practice Address - Country:US
Practice Address - Phone:734-274-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1174826945Medicaid