Organization Active NPI

Elevated Therapy FL LLC

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1063205573
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELEVATED THERAPY FL LLC
Practice address
4100 W Kennedy Blvd Ste 310
Tampa, FL 33609-2290
Phone
(813) 710-5183
Fax
(813) 560-8346
NPI assigned
May 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nciole Head, LCSW
Title
Owner/Psychotherapist
Phone
(813) 753-6860

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4100 W Kennedy Blvd Ste 310
Tampa, FL 33609-2290

Mailing address

4100 W Kennedy Blvd Ste 310
Tampa, FL 33609-2290
Phone (813) 710-5183

National Provider Directory

National Provider Directory

Locations

4100 W Kennedy Blvd
Ste 310
Tampa, FL 33609
Phone (813) 358-6257

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1063205573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD STE 310",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092290",
            "telephone_number": "813-710-5183",
            "fax_number": "813-560-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD STE 310",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092290",
            "telephone_number": "813-710-5183",
            "fax_number": "813-560-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED THERAPY FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "NCIOLE",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "813-753-6860",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.