Healthcare Provider Details

I. General information

NPI: 1013783174
Provider Name (Legal Business Name): ELEVATE MENTAL HEALTH & WELLNESS SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 BRAGG BLVD STE A
FAYETTEVILLE NC
28303-4141
US

IV. Provider business mailing address

PO BOX 62
HOPE MILLS NC
28348-0062
US

V. Phone/Fax

Practice location:
  • Phone: 910-460-3392
  • Fax: 910-218-9182
Mailing address:
  • Phone: 910-460-3392
  • Fax: 910-218-9182

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: MARTHA S QUATTLEBAUM
Title or Position: OWNER
Credential: LCSW
Phone: 910-460-3392