Provider Demographics
NPI:1437774478
Name:ELEVATE COUNSELING FOR CHILDREN AND FAMILIES
Entity Type:Organization
Organization Name:ELEVATE COUNSELING FOR CHILDREN AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACGOVERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-848-8134
Mailing Address - Street 1:45 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1420
Mailing Address - Country:US
Mailing Address - Phone:631-848-8134
Mailing Address - Fax:
Practice Address - Street 1:156 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-5100
Practice Address - Country:US
Practice Address - Phone:860-255-4069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty