Provider Demographics
NPI:1700582319
Name:ELEVATE FAMILY PSYCHIATRY AND THERAPY
Entity Type:Organization
Organization Name:ELEVATE FAMILY PSYCHIATRY AND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:PULLEN
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-383-4405
Mailing Address - Street 1:2909 E ARKANSAS LN # C-465
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6926
Mailing Address - Country:US
Mailing Address - Phone:617-383-4405
Mailing Address - Fax:
Practice Address - Street 1:2909 E ARKANSAS LN # C-465
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6926
Practice Address - Country:US
Practice Address - Phone:617-383-4405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty