Provider Demographics
NPI:1821845389
Name:ELEVATEMIND, LLC
Entity type:Organization
Organization Name:ELEVATEMIND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLORAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:717-632-8400
Mailing Address - Street 1:100 W EISENHOWER DR STE A
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1142
Mailing Address - Country:US
Mailing Address - Phone:717-632-8400
Mailing Address - Fax:717-632-9300
Practice Address - Street 1:100 W EISENHOWER DR STE A
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1142
Practice Address - Country:US
Practice Address - Phone:717-632-8400
Practice Address - Fax:717-632-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty