Healthcare Provider Details

I. General information

NPI: 1700372539
Provider Name (Legal Business Name): ELEVATE BEHAVIOR SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2018
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 MORRISON SPRINGS RD
CHATTANOOGA TN
37415-3401
US

IV. Provider business mailing address

625 MORRISON SPRINGS RD
CHATTANOOGA TN
37415-3401
US

V. Phone/Fax

Practice location:
  • Phone: 423-802-1982
  • Fax:
Mailing address:
  • Phone: 423-802-1982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARENA ELYSE JONES
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: BCBA
Phone: 352-317-8867