MEDICARE: ELEVATE M E COUNSELING, 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1831819127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE M E COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1505 PELHAM RD S STE 7
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-3707
Country	:	US
Telephone Number	:	256-453-7731
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 PELHAM RD S STE 7
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-3707
Country	:	US
Telephone Number	:	256-453-7731
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALISHA D MURPHY
Credential	:	LPC
Telephone Number	:	256-453-7731

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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