ELEVATEEQ HEALTH PLLC NPI 1649078395

NPI Information

  • NPI: 1649078395
  • Provider Name: ELEVATEEQ HEALTH PLLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 12724 GRAN BAY PKWY W STE 410
    JACKSONVILLE, FL
    ZIP 32258
  • Phone: (612) 408-1431

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NPI Details

ELEVATEEQ HEALTH PLLC is a mental health (including community mental health center) clinic center in Jacksonville, FL. ELEVATEEQ HEALTH PLLC NPI is 1649078395. The provider is registered as an organization entity type.

The provider's business location address is:

12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL
ZIP 32258-486
Phone: (612) 408-1431

The provider's authorized official is Jenner Omodt .
The authorized official title is Owner and has the following contact phone number (612) 408-1431.

The enumeration date for this NPI number is 3/6/2025 and was last updated on 3/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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