REVIVICATION COUNSELING SERVICES (NPI# 1912561713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912561713 |
| Entity Type | Organization |
| Organization Name | REVIVICATION COUNSELING SERVICES |
| Practice Address |
814 Cripple Creek Lane Suffolk VA 23434 |
| Practice Telephone | 7575829567 |
| Mailing Telephone | 7575829567 |
| Mailing Fax Number | 7578091159 |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-26 |
| Authorized Official Name | LEVITICUS LOFTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7575829567 |
| Authorized Official Credential | MSW, LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| 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 | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
814 CRIPPLE CREEK LANE |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235780255 | Chiquita Savage | Home Health | You 1st Healthcare, 112 West Washington Street Suite 502, Suffolk, VA 23434 | 2019-09-20 |
| 1558826958 | Nita Jenkins | Non-emergency Medical Transport (VAN) | 707 Gittings St. Suite 105, Suffolk, VA 23434 | 2019-02-10 |
| 1730660952 | Latrese L Riddick | Driver | 418 Jackson St, Suffolk, VA 23434 | 2018-08-25 |
| 1114411279 | Percilla D Zeno | Community Health Worker | 102 Niblick Cir, Suffolk, VA 23434 | 2018-06-21 |
| 1437652765 | Aprele Gaddie | Health Educator | 2769 Godwin Boulevard, Suffolk, VA 23434 | 2018-03-13 |
| 1598284283 | Domonic Teheran Scott | Driver | 102 Brewer Ave, Suffolk, VA 23434 | 2017-09-13 |
| 1578089397 | Nakia Shantel Francis | Nurse Practitioner | 2970 Godwin Blvd, Suite 320, Suffolk, VA 23434 | 2017-08-15 |
| 1679093009 | Daisy Mae Aba, LLC | Behavioral Analyst | 3212 Clearcreek Rd., Suffolk, VA 23434 | 2017-06-27 |
| 1114457736 | Better Care Family Homes | Day Training, Developmentally Disabled Services | 813 West Washington Street, Suffolk, VA 23434 | 2017-06-15 |
| 1013464510 | Lovable Homecare LLC | Home Health | 323 York Strret, Suffolk, VA 23434 | 2016-09-01 |
| Find all providers in zip 23434 | ||||
| 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 |
|---|---|---|---|---|
| 1164046249 | Professional Alternative Visions LLC | Community/Behavioral Health | 2717 E Washington St, Suffolk, VA 23434-2619 | 2020-06-03 |
| 1306491592 | Kjln Inc. | Community/Behavioral Health | 4208 Helen St, Suffolk, VA 23435-2138 | 2019-08-05 |
| 1356848055 | Tri-cities Adult Services LLC | Community/Behavioral Health | 145 Lee St Unit A, Suffolk, VA 23434-5346 | 2018-04-09 |
| 1255850574 | Dantel Health, LLC | Community/Behavioral Health | 234 Meadow View Blvd, Suffolk, VA 23435-3495 | 2017-09-18 |
| 1245758135 | Crossroads Treatment Center of Suffolk, PC | Community/Behavioral Health | 1258 Holland Rd, Suffolk, VA 23434-6313 | 2017-08-31 |
| 1023460342 | 5 Star Residential Care | Community/Behavioral Health | 5024 Kelso St, Suffolk, VA 23435-2391 | 2016-07-11 |
| 1376964783 | Comingout Christian Outreach Org. | Community/Behavioral Health | 1021 Nicklaus Dr, Suffolk, VA 23435-4102 | 2014-01-02 |
| 1033491048 | Institute for Family Centered Services | Community/Behavioral Health | 7021 Harbour View Blvd, Suite 102, Suffolk, VA 23435-2869 | 2011-09-15 |
| 1255629879 | Advantage Rehab Inc | Community/Behavioral Health | 6705 Castlewood Cir, Suffolk, VA 23435-3016 | 2011-07-17 |
| 1801184619 | Tks Consulting, LLC | Community/Behavioral Health | 241 Purple Martin Ln, Suffolk, VA 23435-3329 | 2011-07-13 |
| Find all providers in SUFFOLK | ||||
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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.