MEDICARE: ELEVATED ABA & CONSULTING, LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1558228957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATED ABA & CONSULTING, LLC

Provider Business Mailing Address
First Line	:	4091 OVERTURE CIR
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-5883
Country	:	US
Telephone Number	:	941-500-4761
Fax Number	:

Provider Business Practice Location Address
First Line	:	4091 OVERTURE CIR
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-5883
Country	:	US
Telephone Number	:	941-500-4761
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER, BEHAVIOR SERVICE DIRECTOR
Name	:	SARA BARNES DOUGHERTY
Credential	:	EDD, BCBA
Telephone Number	:	941-500-4761

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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