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General NPI Number Information
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NPI Number | 1306725478
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Entity Type | Organization
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Legal Business Name | ELEVATED INTIMACY, INC., LICENSED CLINICAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 610 E CANON PERDIDO ST APT 9
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City | SANTA BARBARA
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State | CA
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Zip | 93103-3037
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Country | US
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Telephone | 805-666-1022
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Fax | 805-254-0441
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Provider Business Mailing Address
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Address Line | 1117 STATE ST # 1001
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City | SANTA BARBARA
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State | CA
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Zip | 93101-2712
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Country | US
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Telephone | 805-666-1022
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Fax | 805-254-0441
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Authorized Official
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Title or Position | CEO
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Name | DR. JUSTINE MEADOR
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Credential | PHD, LCSW-S, CST
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Telephone | 805-666-1022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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