Provider Demographics
NPI:1396356101
Name:ELEVATED PSYCHOTHERAPY PLC
Entity Type:Organization
Organization Name:ELEVATED PSYCHOTHERAPY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:319-853-8659
Mailing Address - Street 1:702 S GILBERT ST STE 109
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1738
Mailing Address - Country:US
Mailing Address - Phone:319-853-8659
Mailing Address - Fax:
Practice Address - Street 1:702 S GILBERT ST STE 109
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1738
Practice Address - Country:US
Practice Address - Phone:319-853-8659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty