Healthcare Provider Details

I. General information

NPI: 1922925163
Provider Name (Legal Business Name): ELEVATION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E 14TH ST
IDAHO FALLS ID
83404-5911
US

IV. Provider business mailing address

3630 E 300 N
RIGBY ID
83442-5418
US

V. Phone/Fax

Practice location:
  • Phone: 801-787-4862
  • Fax:
Mailing address:
  • Phone: 801-787-4862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY SMITH
Title or Position: OWNER/COUNSELOR
Credential: LCSW
Phone: 801-787-4862