Healthcare Provider Details

I. General information

NPI: 1205791522
Provider Name (Legal Business Name): ELEVARE WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 SOUTHWEST FWY STE 101
HOUSTON TX
77098-4520
US

IV. Provider business mailing address

3120 SOUTHWEST FWY STE 101
HOUSTON TX
77098-4520
US

V. Phone/Fax

Practice location:
  • Phone: 410-441-3916
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA V. GIVENS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 410-441-3916