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General NPI Number Information
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NPI Number | 1326562919
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Entity Type | Organization
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Legal Business Name | ELEVATE COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 1935 COUNTY ROAD B2 W STE 240
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City | ROSEVILLE
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State | MN
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Zip | 55113-2722
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Country | US
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Telephone | 612-590-5752
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Fax | 844-407-4565
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Provider Business Mailing Address
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Address Line | 411 3RD ST SE
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City | OSSEO
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State | MN
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Zip | 55369-1606
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Country | US
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Telephone | 763-600-7572
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Fax | 844-407-4565
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | REBECCA JOY ADAMS
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Credential | MA, LMFT
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Telephone | 763-600-7572
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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 | 2062
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License Number State | MN
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