Self Elevation Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SELF ELEVATION THERAPY LLC

Practice address

39150 Dequindre Rd # Suire200
Sterling Heights, MI 48310-6989

Phone

(248) 444-8582

NPI assigned

Dec 5, 2022

Organization subpart

No

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

Authorized official

Name

Olivia Abouna, LMSWNPI 1619516085

Title

Owner

Phone

(248) 444-8582

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Olivia Abouna

  • Clinical Social Worker
  • Southfield, MI
  • NPI 1619516085
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1356051965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250935",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483250935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39150 DEQUINDRE RD # SUIRE200",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106989",
            "telephone_number": "248-444-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF ELEVATION THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "ABOUNA",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-444-8582",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.