Provider Demographics
NPI:1275256323
Name:ELITE PSYCHIATRY
Entity Type:Organization
Organization Name:ELITE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ELBERT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:859-312-2004
Mailing Address - Street 1:3486 WINTHROP DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4339
Mailing Address - Country:US
Mailing Address - Phone:859-312-2004
Mailing Address - Fax:
Practice Address - Street 1:3499 LANSDOWNE DR STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1154
Practice Address - Country:US
Practice Address - Phone:859-575-2068
Practice Address - Fax:859-575-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty