ALYSSA REVUELTA (NPI# 1871780213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871780213 |
Entity Type | Individual |
Full Name | ALYSSA REVUELTA |
Credential | PH.D. |
Practice Address |
10 Resolute Ln Suite 207 Mt Pleasant SC 29464-6608 |
Practice Telephone | 8438109682 |
Practice Fax Number | 8434084478 |
Mailing Telephone | 8438109682 |
Mailing Fax Number | 8434084478 |
Enumeration Date | 2007-10-01 |
Last Update Date | 2012-11-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1184 | SC | Behavioral Health & Social Service Providers |
Street Address |
10 RESOLUTE LN SUITE 207 |
City | MT PLEASANT |
State | SC |
Zip Code | 29464-6608 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
Find all providers in zip 29464 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336680438 | Charleston Pediatric Psychology, LLC | Psychologist | 222 W Coleman Blvd, Suite 116, Mt Pleasant, SC 29464-3588 | 2017-03-09 |
1285013904 | Chelsea Grimsley Oswald | Psychologist | 222 W Coleman Blvd, Suite 116, Mt Pleasant, SC 29464-3588 | 2015-05-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992100028 | Margaret Vansciver | Psychologist | 29 Leinbach Dr Ste D2, Charleston, SC 29407-7086 | 2014-10-31 |
1457506263 | Susan Stevens Pickett | Psychologist | 10 Pinckney Colony Road, Bldg 300, Bluffton, SC 29909-4126 | 2008-11-20 |
1235219841 | Family Stabilizations LLC | Psychologist | 504 Miller Rd, Sumter, SC 29150-3366 | 2006-10-17 |
1053927004 | Kathryn L Marsh | Psychologist | 1505 Blanding St, Columbia, SC 29201-2906 | 2020-09-16 |
1649671413 | Rebecca J Cavazos Morrow | Psychologist | 403 Stony Landing Rd, Moncks Corner, SC 29461-3967 | 2014-09-11 |
1629490701 | Kristina Kania Bates | Psychologist | 200 Patewood Dr, Suite A200, Greenville, SC 29615-3593 | 2014-01-09 |
1639417157 | Emily Powell Lowell | Psychologist | 9 Richland Medical Park Dr Ste 210, Columbia, SC 29203-6859 | 2013-01-17 |
1558608844 | Julie S Jones, Psy.d., LLC | Psychologist | 419 Se Main St Ste 300, Simpsonville, SC 29681-2676 | 2013-01-07 |
1538404207 | Oliver Keadle Jr. | Psychologist | 1585 Jonesville Hwy, Union, SC 29379-9790 | 2012-12-06 |
1558606855 | Michael Nolan | Psychologist | 1585 Jonesville Hwy, Union, SC 29379 | 2012-11-28 |
Find all providers with the same taxonomy |
City | MT PLEASANT |
Zip Code | 29464 |
Please comment or provide details below to improve the information on ALYSSA REVUELTA.
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.