MEDICARE: ELEVATE APPLIED BEHAVIOR ANALYSIS CONSULTING LLC

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1780542100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE APPLIED BEHAVIOR ANALYSIS CONSULTING LLC

Provider Business Mailing Address
First Line	:	48 BROWN THRASHER CT
Second Line	:
City	:	PORT WENTWORTH
State	:	GA
Zip	:	31407-3640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 BROWN THRASHER CT
Second Line	:
City	:	PORT WENTWORTH
State	:	GA
Zip	:	31407-3640
Country	:	US
Telephone Number	:	502-435-2010
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KENDALL DOWNING
Credential	:	BCBA
Telephone Number	:	502-435-2010

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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