MEDICARE: ELIVAT COLLECTIVE PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1487587119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIVAT COLLECTIVE PLLC

Provider Business Mailing Address
First Line	:	83 E 28TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5584
Country	:	US
Telephone Number	:	929-568-7688
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 BRICKELL AVE STE 1550
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-2824
Country	:	US
Telephone Number	:	929-568-7688
Fax Number	:

Authorized Official
Title or Position	:	OWNER / MANAGING MEMBER
Name	:	COURTNEY P PINCKNEY
Credential	:	LCSW
Telephone Number	:	929-568-7688

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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