Healthcare Provider Details

I. General information

NPI: 1073475166
Provider Name (Legal Business Name): ELEVATED CLINICAL PRACTICE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E PIKES PEAK AVE
COLORADO SPRINGS CO
80909-8006
US

IV. Provider business mailing address

2301 E PIKES PEAK AVE
COLORADO SPRINGS CO
80909-8006
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • 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: MR. KUSH DESAI
Title or Position: OWNER
Credential: LCSW, ACS
Phone: --