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NPI Code Detail

MEDICARE: ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION

MEDICARE: ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1306725478
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION
Provider Business Mailing Address
First Line : 1117 STATE ST # 1001
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93101-2712
Country : US
Telephone Number : 805-666-1022
Fax Number : 805-254-0441
Provider Business Practice Location Address
First Line : 610 E CANON PERDIDO ST APT 9
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93103-3037
Country : US
Telephone Number : 805-666-1022
Fax Number : 805-254-0441
Authorized Official
Title or Position : CEO
Name : DR. JUSTINE MEADOR
Credential : PHD, LCSW-S, CST
Telephone Number : 805-666-1022
Provider Enumeration Date : 09/01/2025
Last Update Date : 09/01/2025

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Directions to “ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION ” Practice Location

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