Healthcare Provider Details

I. General information

NPI: 1588593420
Provider Name (Legal Business Name): ELEVATED HEALING CO., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3606 E BASELINE RD
PHOENIX AZ
85042-7202
US

IV. Provider business mailing address

3606 E BASELINE RD
PHOENIX AZ
85042-7202
US

V. Phone/Fax

Practice location:
  • Phone: 602-488-4045
  • Fax:
Mailing address:
  • Phone: 602-488-4045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. AALIYAH KENISHA CAULTON
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 602-488-4045