| Elevate Health And Wellness | |
|
179 Post Rd W Westport CT 06880-4602 | |
| (203) 450-4882 | |
| (866) 505-8927 |
| Full Name | Elevate Health And Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 179 Post Rd W, Westport, Connecticut |
| Authorized Official Name and Position | Mohamed Elsamra (OWNER AND MANAGER) |
| Authorized Official Contact | 2034504882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevate Health And Wellness 179 Post Rd W Westport CT 06880-4602 Ph: (203) 450-4882 | Elevate Health And Wellness 179 Post Rd W Westport CT 06880-4602 Ph: (203) 450-4882 |
| NPI Number | 1730623737 |
|---|---|
| Provider Enumeration Date | 12/09/2016 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Medicare PECOS PAC ID | 9830535723 |
|---|---|
| Medicare Enrollment ID | O20240314000324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730623737 | NPI | - | NPPES |
| Provider Name | Mohamed Elsamra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457464406 PECOS PAC ID: 3274537675 Enrollment ID: I20110601000751 |
| Provider Name | Jaclyn Birn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205353919 PECOS PAC ID: 6507130648 Enrollment ID: I20170927004657 |
| Provider Name | Jennifer Lynn Hrbek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245761154 PECOS PAC ID: 8022361427 Enrollment ID: I20181101002295 |
| Provider Name | Carolyn Grace Dennett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427145457 PECOS PAC ID: 0446258255 Enrollment ID: I20201117002220 |
| Provider Name | Genesis M Ladinez Velez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255044517 PECOS PAC ID: 1557724390 Enrollment ID: I20230828002202 |
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