Healthcare Provider Details

I. General information

NPI: 1003739558
Provider Name (Legal Business Name): E.L.E.V.A.T.E. COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 LAYNE STREET EXT
FARMVILLE VA
23901-3069
US

IV. Provider business mailing address

2720 LAYNE STREET EXT
FARMVILLE VA
23901-3069
US

V. Phone/Fax

Practice location:
  • Phone: 434-603-7829
  • Fax:
Mailing address:
  • Phone: 434-603-7829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAQUITA S WILLIAMS
Title or Position: OWNER
Credential: E.D.D, LPC-S, CSOTP
Phone: 434-603-7829