Organization
ELEVATION COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIARRA C CARTER LPC,LCAS (LPC/CEO)
(336) 908-9936
Entity
Organization
Contact information
Practice address
1922 S MARTIN LUTHER KING JR DR STE 27, WINSTON SALEM, NC 27107-1361
(336) 908-9936
Mailing address
1922 S. MARTIN LUTHER KING JR. DR., BOX 4, WINSTON SALEM, NC 27107
(336) 908-9936
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558743542
—
NC
Enumeration date
08/21/2019
Last updated
08/21/2019
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