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NPI 1477031383

NPI 1477031383 : ELEVATION COUNSELING SERVICES, LLC : CHESAPEAKE, VA

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General NPI Number Information
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    NPI Number           |    1477031383
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    Entity Type          |    Organization 
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    Legal Business Name  |    ELEVATION COUNSELING SERVICES, LLC 
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Dates
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    Enumeration Date     |    08/02/2018
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    Last Update Date     |    08/02/2018
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Provider Practice Location Address
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    Address Line         |    638 INDEPENDENCE PKWY STE 240 
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    City                 |    CHESAPEAKE
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    State                |    VA
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    Zip                  |    23320-5222
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    Country              |    US
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    Telephone            |    808-505-0542
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    638 INDEPENDENCE PKWY STE 240 
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    City                 |    CHESAPEAKE
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    State                |    VA
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    Zip                  |    23320-5222
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    Country              |    US
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    Telephone            |    808-505-0542
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JANIKA  JOYNER 
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    Credential           |    LCSW
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    Telephone            |    805-505-0542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    0904009811
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    License Number State |    VA
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