MEDICARE: ELEVATED HEALING CO., 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	:	1588593420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATED HEALING CO., PLLC

Provider Business Mailing Address
First Line	:	3606 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-7202
Country	:	US
Telephone Number	:	602-488-4045
Fax Number	:

Provider Business Practice Location Address
First Line	:	3606 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-7202
Country	:	US
Telephone Number	:	602-488-4045
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	DR. AALIYAH KENISHA CAULTON
Credential	:	LCSW
Telephone Number	:	602-488-4045

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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