MEDICARE: ELEVATION THERAPY INC

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	:	1770280653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATION THERAPY INC

Provider Business Mailing Address
First Line	:	25 JUNCTION LN
Second Line	:
City	:	SOUTH HAMILTON
State	:	MA
Zip	:	01982-1540
Country	:	US
Telephone Number	:	978-996-4078
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 CONSTITUTION LN STE 1C
Second Line	:
City	:	DANVERS
State	:	MA
Zip	:	01923-3658
Country	:	US
Telephone Number	:	978-996-4078
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	KASSANDRA VICTORIA GARCIA
Credential	:	LICSW
Telephone Number	:	978-996-4078

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	08/23/2023

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Directions to “ELEVATION THERAPY INC ” Practice Location

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