REVIVE WELLNESS (NPI# 1912443094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912443094 |
| Entity Type | Organization |
| Organization Name | REVIVE WELLNESS |
| Practice Address |
119 Harry St First Floor Conshohocken PA 19428 |
| Mailing Address |
119 Harry Street Conshohocken PA 19428 |
| Practice Telephone | 6104578542 |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-05-04 |
| Authorized Official Name | LEIZA STANLEY (OWNER) |
| Authorized Official Telephone | 6404578542 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | CW016642 | PA | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | REVIVE WELLNESS AND CHIROPRACTIC CENTER, INC. | 808 5th St., 4, Coralville, IA 52241 |
| Washington State Corporations | REVIVE WELLNESS AND MEDICAL AESTHETICS, LLC | 1146 Commerce Ave, Longview, WA 98632-3025 |
| Colorado Business Entities | Revive Wellness Center LLC | 6657 W Ottawa Ave, A11, Littleton, CO 80128 |
| Connecticut Business Registrations | REVIVE WELLNESS CENTER, LLC | 867-869 Whalley Avenue, New Haven, CT 06515 |
| Colorado Business Entities | Revive Wellness Group, LLC | 6730 Northface Lane, Colorado Springs, CO 80919 |
| Colorado Business Entities | Revive Wellness LLC | 74 Forest Lane, Tabernash, CO 80478 |
| New York State Corporations | REVIVE WELLNESS, INC. | 58 Denise Street, Sag Harbor, Ny 11963 |
| Colorado Business Entities | Revive Wellness, LLC | 5563 Spine Road #301, Boulder, CO 80301 |
| Street Address |
119 HARRY ST FIRST FLOOR |
| City | CONSHOHOCKEN |
| State | PA |
| Zip Code | 19428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467901793 | Mental Balance- Cognitive Behavioral Therapy | Community/Behavioral Health | 119 Harry St, First Floor, Conshohocken, PA 19428-1821 | 2016-09-28 |
| 1215419346 | Devann Lynn Wisniewski | Social Worker | 119 Harry St, Conshohocken, PA 19428-1821 | 2018-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395149 | Kellan Katra | Physician Assistant | 400 Fayette Street, Suite 180, Conshohocken, PA 19428 | 2020-01-10 |
| 1275170151 | Barbara G. Hedges-hoffman | Counselor | 20 E 9th Ave Ste 100, Conshohocken, PA 19428 | 2019-12-10 |
| 1184102105 | Experience Chiropractic East, LLC | Chiropractor | 3038 Butler Pike, Conshohocken, PA 19428 | 2018-08-01 |
| 1861986713 | Bridget Mary Parkes | Speech-Language Pathologist | 301 Harry St, Conshohocken, PA 19428 | 2018-06-14 |
| 1588155857 | Intouch Med Supply | Mastectomy Fitter | 529 Fayette St, Conshohocken, PA 19428 | 2018-05-22 |
| 1841796711 | Davita Medical Group Philadelphia, LLC | Internal Medicine | 300 Four Falls Corporate Center, 300 Conshohocken State Rd., West Conshohocken, PA 19428 | 2018-04-01 |
| 1538600853 | Dermone Dermatology Associates of The Keystone State, P.c | Dermatology | 200 Barr Harbor Drive, Four Tower Bridge, Suite 200, West Conshohocken, PA 19428 | 2017-03-20 |
| 1891156766 | Kaitlyn Oliver | Speech-Language Pathologist | 1200 River Road, Aim Academy-, Conshohocken, PA 19428 | 2016-03-18 |
| 1992122782 | Titleman Orthopedics LLC | Prosthetic/Orthotic Supplier | 1100 E Hector St Ste 390, Conshohocken, PA 19428 | 2014-03-18 |
| 1447543004 | Barbara P. Mastriano | Speech-Language Pathologist | One West Elm St. Suite 100, Mercylife Program, Conshohocken, PA 19428 | 2011-05-16 |
| Find all providers in zip 19428 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467901793 | Mental Balance- Cognitive Behavioral Therapy | Community/Behavioral Health | 119 Harry St, First Floor, Conshohocken, PA 19428-1821 | 2016-09-28 |
| 1336633452 | Kate Altman Psyd LLC | Community/Behavioral Health | 923 Fayette St, Conshohocken, PA 19428-1531 | 2018-06-21 |
| 1487060638 | National Mentor Healthcare LLC, D.b.a. Pa Mentor | Community/Behavioral Health | 625 W Ridge Pike, Bldg B, Suite 102, Conshohocken, PA 19428-1180 | 2014-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447115 | Forward Plan LLC | Community/Behavioral Health | 900 Macfarlane Dr, Pittsburgh, PA 15235-4230 | 2020-11-06 |
| 1821699240 | Eternal Renewal, LLC | Community/Behavioral Health | 501 N Charlotte St Fl 2, Pottstown, PA 19464-4602 | 2020-11-03 |
| 1417557174 | Kensington Hospital Non Hospital Short Term/long Term Rehab | Community/Behavioral Health | 136 W. Diamond St, Philadelphia, PA 19122-1721 | 2020-10-30 |
| 1699373415 | Maternity Care Coalition | Community/Behavioral Health | 401 Dekalb St, Norristown, PA 19401-4909 | 2020-10-14 |
| 1558969741 | Centerville Clinics Inc | Community/Behavioral Health | Centerville Clinics-intensive Behavioral Health Service, 37 Highland Avenue, Washington, PA 15301-4062 | 2020-10-12 |
| 1023624202 | Allied Health Care Services | Community/Behavioral Health | 1124 Scott St, Wilkes Barre, PA 18705-3737 | 2020-09-22 |
| 1518573708 | Mental Health Solution | Community/Behavioral Health | 2671 Darlington Rd, Beaver Falls, PA 15010-1280 | 2020-09-22 |
| 1629684584 | Peace & Clarity Counseling LLC | Community/Behavioral Health | 1 E Broad St Ste 130-1096, Bethlehem, PA 18018-5913 | 2020-09-16 |
| 1548874746 | Room 2 Grow, LLC | Community/Behavioral Health | 7500 Brooktree Rd Ste 201, Wexford, PA 15090-9285 | 2020-09-04 |
| 1134733819 | Keeping It Real Counseling, LLC | Community/Behavioral Health | 2937 Route 611 Unit 9a, Tannersville, PA 18372-6000 | 2020-09-01 |
| Find all providers with the same taxonomy | ||||
| City | CONSHOHOCKEN |
| Zip Code | 19428 |
Please comment or provide details below to improve the information on REVIVE WELLNESS.
| 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.