Healthcare Provider Details

I. General information

NPI: 1336056191
Provider Name (Legal Business Name): ELEVATED LIFE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 HORIZON CT STE 220
GRAND JCT CO
81506-3939
US

IV. Provider business mailing address

744 HORIZON CT STE 220
GRAND JCT CO
81506-3939
US

V. Phone/Fax

Practice location:
  • Phone: 970-478-1101
  • Fax:
Mailing address:
  • Phone: 970-478-1101
  • 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: JOANNA ROGERS
Title or Position: OWNER
Credential: LCSW
Phone: 970-478-1101