| Elevation Counseling And Consulting Llc | |
|
17505 N 79th Ave Ste 304a Glendale AZ 85308-8729 | |
| (623) 606-5522 | |
| (623) 878-5800 |
| Full Name | Elevation Counseling And Consulting Llc |
|---|---|
| Speciality | Social Worker |
| Location | 17505 N 79th Ave Ste 304a, Glendale, Arizona |
| Authorized Official Name and Position | Shannon R Martin (SOLE OWNER) |
| Authorized Official Contact | 6236065522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevation Counseling And Consulting Llc 7558 W Thunderbird Rd Ste 1-492 Peoria AZ 85381-6080 Ph: (623) 606-5522 | Elevation Counseling And Consulting Llc 17505 N 79th Ave Ste 304a Glendale AZ 85308-8729 Ph: (623) 606-5522 |
| NPI Number | 1699435230 |
|---|---|
| Provider Enumeration Date | 12/22/2021 |
| Last Update Date | 12/22/2021 |
| Certification Date | 12/22/2021 |
| Medicare PECOS PAC ID | 7315345287 |
|---|---|
| Medicare Enrollment ID | O20220131002038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699435230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shannon R Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962708685 PECOS PAC ID: 4688822570 Enrollment ID: I20120918000906 |
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