Provider Demographics
NPI:1568092195
Name:ELEVATE THERAPY & ASSESSMENT, PLLC
Entity Type:Organization
Organization Name:ELEVATE THERAPY & ASSESSMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SANDBULTE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:712-240-2785
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51351-0132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 10TH ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IA
Practice Address - Zip Code:51351-1530
Practice Address - Country:US
Practice Address - Phone:712-338-6200
Practice Address - Fax:712-338-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty