REVITALIST NPI 1073168241

NPI Information

  • NPI: 1073168241
  • Provider Name: REVITALIST
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • CLIA Number: 44D2249257
  • Address: 10608 FLICKENGER LN
    KNOXVILLE, TN
    ZIP 37922
  • Phone: (865) 392-6262

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NPI Details

REVITALIST is a community behavioral health in Knoxville, TN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. REVITALIST NPI is 1073168241. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10608 FLICKENGER LN
KNOXVILLE, TN
ZIP 37922-485
Phone: (865) 392-6262

The provider's authorized official is Kathryn Walker .
The authorized official title is Principal Employee and has the following contact phone number (865) 392-6262.

The CLIA number assigned to this NPI record is 44D2249257 - independent with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/5/2019 and was last updated on 3/7/2025.

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
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessionalNo
3103T00000XPsychologistNo
4103TC1900XPsychologistCounselingNo
5251S00000XCommunity/Behavioral HealthYes
6261QI0500XClinic/CenterInfusion TherapyNo
7261QM1300XClinic/CenterMulti-SpecialtyNo

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: 11/21/2025

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