Healthcare Provider Details

I. General information

NPI: 1477471811
Provider Name (Legal Business Name): ELEVATE: MENTAL HEALTH AND PERFORMANCE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5260 N TOLER DR
BEL AIRE KS
67226-6632
US

IV. Provider business mailing address

300 W DOUGLAS AVE STE 625
WICHITA KS
67202-2917
US

V. Phone/Fax

Practice location:
  • Phone: 618-946-6563
  • Fax:
Mailing address:
  • Phone: 618-946-6563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN R FLOWERS
Title or Position: MENTAL HEALTH COUNSELOR
Credential: M.ED., LPC
Phone: 618-946-6563