Elevate Wellness Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ELEVATE WELLNESS COUNSELING LLC

Practice address

1100 SW 6TH Ave Ste 1600
Portland, OR 97204-1017

Phone

(801) 867-5838

NPI assigned

Mar 19, 2025

Organization subpart

No

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

Authorized official

Name

Jacob Russell Moss, LCSWNPI 1053621912

Title

Member

Phone

(801) 867-5838

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jacob Russell Moss

  • Social Worker
  • Portland, OR
  • NPI 1053621912
  NPD Authorized official

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1700686557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SW CEDAR HILLS BLVD # 1110",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051354",
            "telephone_number": "801-867-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SW 6TH AVE STE 1600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041017",
            "telephone_number": "801-867-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE WELLNESS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-867-5838",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "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": []
}

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• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.