Elevate Psychology PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ELEVATE PSYCHOLOGY PLLC

Practice address

4810 Point Fosdick Dr #163
Gig Harbor, WA 98335-1711

Phone

(253) 265-5584

NPI assigned

Dec 1, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Carlile, PH.D.NPI 1124354121

Title

Clinical Psychologist

Phone

(206) 590-4094

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

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

• Jessica Carlile, PHD

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1124354121
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1952906687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 POINT FOSDICK DR #163",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351711",
            "telephone_number": "253-265-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 POINT FOSDICK DR #163",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351711",
            "telephone_number": "253-265-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "CARLILE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "206-590-4094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Alfred Edwards, PH.D.
• Candy L Egan
• Laura Egbert, MD
• Eid, Jaber, Jassar PLLC
• Mohamed Ali Elagnaf
• Laura A Elliott, M.A.
• Joshua B Elston, MD
• Teresa M Eltrich, MS
• Cathryn Elvins, OTR L
• Adam Elwir

• Clinical Psychologist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.