MEDICARE: ELEMENTS OF LIFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083495311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEMENTS OF LIFE

Provider Business Mailing Address
First Line	:	3143 BELLE GROVE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2620
Country	:	US
Telephone Number	:	190-160-6481
Fax Number	:

Provider Business Practice Location Address
First Line	:	3143 BELLE GROVE RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38115-2620
Country	:	US
Telephone Number	:	901-606-4811
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ELIZABETH TOLLIVER
Credential	:
Telephone Number	:	901-606-4811

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	03/11/2026

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Directions to “ELEMENTS OF LIFE ” Practice Location

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