Healthcare Provider Details

I. General information

NPI: 1689542292
Provider Name (Legal Business Name): ELEVATE PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 201
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 201
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 202-989-3001
  • Fax:
Mailing address:
  • Phone: 202-989-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: AMY HENRY
Title or Position: OWNER & LICENSED PSYCHOTHERAPIST
Credential: LCPC, LPC
Phone: 202-989-3001