Provider Demographics
NPI:1770280653
Name:ELEVATION THERAPY INC
Entity type:Organization
Organization Name:ELEVATION THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-996-4078
Mailing Address - Street 1:25 JUNCTION LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1540
Mailing Address - Country:US
Mailing Address - Phone:978-996-4078
Mailing Address - Fax:
Practice Address - Street 1:85 CONSTITUTION LN STE 1C
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3658
Practice Address - Country:US
Practice Address - Phone:978-996-4078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty