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General NPI Number Information
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NPI Number | 1144046004
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Entity Type | Organization
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Legal Business Name | ELEVATE MINDCARE STUDIO LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 1301 SW TOPEKA BLVD STE 122
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City | TOPEKA
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State | KS
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Zip | 66612-1942
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Country | US
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Telephone | 785-274-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 2524 SW BURNETT RD
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City | TOPEKA
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State | KS
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Zip | 66614-1208
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Country | US
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Telephone | 785-393-8446
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. ANGELICA CROWLEY
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Credential | LMSW, LMAC
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Telephone | 785-393-8846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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