Basic Information
| Provider Information | |||||||||
| NPI: | 1841942919 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ELEVATE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2178 S DUDLEY ST | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802272318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202808781 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4340 E KENTUCKY AVE STE 365 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802462075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7202808781 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2022 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | TORRES | ||||||||
| AuthorizedOfficialFirstName: | SONIA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7202808781 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.