REVENTION PSYCHIATRY & NEUROLOGY, LLC (NPI# 1669859559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669859559 |
Entity Type | Organization |
Organization Name | REVENTION PSYCHIATRY & NEUROLOGY, LLC |
Practice Address |
8002 Mcewen Rd Centerville OH 45458-2033 |
Practice Telephone | 9376819507 |
Mailing Telephone | 9372603156 |
Enumeration Date | 2015-04-30 |
Last Update Date | 2015-04-30 |
Authorized Official Name | CHARLES M MISJA (PRESIDENT) |
Authorized Official Telephone | 9372603156 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
Y | 2084B0040X |
Psychiatry & Neurology Specialization: Behavioral Neurology & Neuropsychiatry |
Allopathic & Osteopathic Physicians |
Street Address |
8002 MCEWEN RD |
City | CENTERVILLE |
State | OH |
Zip Code | 45458-2033 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265801195 | Internal Medicine of Centerville, LLC | Internal Medicine | 8002 Mcewen Rd, Centerville, OH 45458-2033 | 2015-09-22 |
1871970566 | Revention Recovery Services, LLC | Counselor | 8002 Mcewen Rd, Centerville, OH 45458-2033 | 2015-05-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255948170 | John M Duchak Md Cardiology LLC | Specialist | 1036 Wild Hickory Lane, Centerville, OH 45458 | 2020-09-24 |
1942833389 | Colleen Stevens | Counselor | 955 Sweeney Drive, Dayton, OH 45458 | 2020-02-13 |
1740770197 | Social Row Transitional Care, Inc. | Skilled Nursing Facility | 250 West Social Row Road, Centerville, OH 45458 | 2018-05-11 |
1326568833 | Mary Ann Horton | Registered Nurse | 1362 Hickoryview Ct, Dayton, OH 45458 | 2017-06-26 |
1487101911 | Brianna Burkman | Specialist/Technologist | 1400 Stone Ash Ct, Centerville, OH 45458 | 2016-09-01 |
1720434707 | Ascent Health, LLC | Community/Behavioral Health | 1162 Peachcreek Rd., Dayton, OH 45458 | 2016-05-10 |
1821450206 | Chi Living Communties | Skilled Nursing Facility | 1050 St. Leonard Way, Centerville, OH 45458 | 2016-03-24 |
1265842835 | Amanda Powell | Physical Therapist | 9582 Tahoe Drive, Centerville, OH 45458 | 2014-05-05 |
1255774337 | Rita Charlene Penley | Counselor | 99 South Main St, Centerville, OH 45458 | 2013-04-09 |
1447503933 | Martha Ann Sheldrick | Nurse Practitioner | 212 Walnut Grove Dr, Centerville, OH 45458 | 2012-10-21 |
Find all providers in zip 45458 |
Taxonomy Code | 2084B0040X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Behavioral Neurology & Neuropsychiatry |
Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues. |
Notes: Source: National Uniform Claim Committee. [1/1/2012: new] Additional Resources: American Academy of Neurology, www.aan.com. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407325939 | Lswhb LLC | Psychiatry & Neurology | 640 Glenna Dr, Fairfield, OH 45014 | 2018-11-14 |
1578910808 | Eden Counseling Centers LLC Mental Health | Psychiatry & Neurology | 8794 Big Bear Avenue, Powell, OH 43065-9113 | 2016-05-17 |
1922356864 | Jacqueline Vanderburgh | Psychiatry & Neurology | 3545 Olentangy River Rd Ste 220, Columbus, OH 43214-3907 | 2012-08-27 |
City | CENTERVILLE |
Zip Code | 45458 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.