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General NPI Number Information
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NPI Number | 1194549923
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Entity Type | Organization
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Legal Business Name | ELEVATED PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/10/2024
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Provider Practice Location Address
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Address Line | 5900 BALCONES DRIVE SUITE. 100
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City | AUSTIN
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State | TX
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Zip | 78731
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Country | US
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Telephone | 319-853-8659
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Fax |
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Provider Business Mailing Address
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Address Line | 14900 AVERY RANCH BLVD. STE. C200 #3050
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City | AUSTIN
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State | TX
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Zip | 78717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PSYCHOTHERAPIST, SUPERVISOR
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Name | DR. KAITLIN HUTSON
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Credential | PHD, LMFT
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Telephone | 319-853-8659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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