Healthcare Provider Details

I. General information

NPI: 1407708548
Provider Name (Legal Business Name): ELEVATED PATHWAYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2249 N LOOP 336 W STE B
CONROE TX
77304-3639
US

IV. Provider business mailing address

2249 N LOOP 336 W STE B
CONROE TX
77304-3639
US

V. Phone/Fax

Practice location:
  • Phone: 936-444-4220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY MILLER
Title or Position: OWNER
Credential:
Phone: 346-235-9688