Provider Demographics
NPI:1437807922
Name:ELVIVE PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:ELVIVE PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINNARI
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-552-9461
Mailing Address - Street 1:3006 CATALPA ROCK CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3006 CATALPA ROCK CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3946
Practice Address - Country:US
Practice Address - Phone:209-552-9461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty