NPIMap

Organization Active NPI

Elevated Integrative Therapy LLC

  • Clinical Social Worker
  • Port Reading, NJ
National Provider Identifier
1730923756
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ELEVATED INTEGRATIVE THERAPY LLC
Practice address
19 Dawn Dr
Port Reading, NJ 07064-1403
Phone
(571) 357-3722
Fax
(201) 648-2707
NPI assigned
Jun 24, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Sandy AminNPI 1417700030
Title
Counselor/Owner
Phone
(571) 357-3722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

19 Dawn Dr
Port Reading, NJ 07064-1403

Mailing address

19 Dawn Dr
Port Reading, NJ 07064-1403
Phone (571) 357-3722

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1730923756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAWN DR",
            "city": "PORT READING",
            "state": "NJ",
            "postal_code": "070641403",
            "telephone_number": "571-357-3722",
            "fax_number": "201-648-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAWN DR",
            "city": "PORT READING",
            "state": "NJ",
            "postal_code": "070641403",
            "telephone_number": "571-357-3722",
            "fax_number": "201-648-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED INTEGRATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "571-357-3722"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Reading, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.