Provider Demographics
NPI:1952906687
Name:ELEVATE PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:ELEVATE PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLILE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-590-4094
Mailing Address - Street 1:4810 POINT FOSDICK DR #163
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1711
Mailing Address - Country:US
Mailing Address - Phone:253-265-5584
Mailing Address - Fax:
Practice Address - Street 1:4810 POINT FOSDICK DR #163
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1711
Practice Address - Country:US
Practice Address - Phone:253-265-5584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty