MEDICARE: ELEVATE BEHAVIORAL HEALTH, 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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1932049038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	1440 DUCKWOOD DR
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55122-1451
Country	:	US
Telephone Number	:	612-386-7222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 DUCKWOOD DR
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55122-1451
Country	:	US
Telephone Number	:	612-386-7222
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW ROMMEL
Credential	:
Telephone Number	:	612-386-7222

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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