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Organization
ELEVATION THERAPY GROUP LLC
Active
Organization
ELEVATION THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM L IACARINO LCPC (EXECUTIVE DIRECTOR)
(443) 845-0012
Entity
Organization
Contact information
Practice address
1110 BENFIELD BLVD STE H, MILLERSVILLE, MD 21108-2644
(443) 845-0012
(443) 276-2800
Mailing address
8940 OLD ANNAPOLIS RD STE E, COLUMBIA, MD 21045-2129
(443) 845-0012
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
12/28/2022
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