Provider Demographics
NPI:1831072347
Name:ELEVATED BEHAVIOR COUNSELING, LLC
Entity type:Organization
Organization Name:ELEVATED BEHAVIOR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-526-3349
Mailing Address - Street 1:4749 LINCOLN MALL DR STE 20H
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2348
Mailing Address - Country:US
Mailing Address - Phone:773-526-3349
Mailing Address - Fax:
Practice Address - Street 1:4749 LINCOLN MALL DR STE 20H
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2348
Practice Address - Country:US
Practice Address - Phone:773-526-3349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health