Provider Demographics
NPI:1780211870
Name:ELEVATE NEUROPSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:ELEVATE NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SZUCHYT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MSCS, CBIS
Authorized Official - Phone:484-879-4343
Mailing Address - Street 1:533 W UWCHLAN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1763
Mailing Address - Country:US
Mailing Address - Phone:484-879-4343
Mailing Address - Fax:484-879-4632
Practice Address - Street 1:533 W UWCHLAN AVE STE 102
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-1763
Practice Address - Country:US
Practice Address - Phone:610-363-2400
Practice Address - Fax:610-363-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty