REVIVE & THRIVE MENTAL HEALTH LLC NPI 1356003628

NPI Information

NPI: 1356003628
Provider Name: REVIVE & THRIVE MENTAL HEALTH, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
4013 N RIDGE RD STE 110
WICHITA, KS
ZIP 67205
Phone: (316) 631-2454
Get Directions

REVIVE & THRIVE MENTAL HEALTH, LLC is a psychiatric/mental health nurse practitioner in Wichita, KS. REVIVE & THRIVE MENTAL HEALTH, LLC NPI is 1356003628. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4013 N RIDGE RD STE 110
WICHITA, KS
ZIP 67205-859
Phone: (316) 631-2454
Fax: (316) 247-6062

The provider's authorized official is Kimberlee Craig .
The authorized official title is Credentialing Specialist and has the following contact phone number (316) 201-6294.

The enumeration date for this NPI number is 10/13/2021 and was last updated on 5/10/2023.

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	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	101YP2500X	Counselor	Professional	No
4	103T00000X	Psychologist		No
5	103TB0200X	Psychologist	Cognitive & Behavioral	No
6	103TC0700X	Psychologist	Clinical	No
7	103TC1900X	Psychologist	Counseling	No
8	103TC2200X	Psychologist	Clinical Child & Adolescent	No
9	104100000X	Social Worker		No
10	1041C0700X	Social Worker	Clinical	No
11	106H00000X	Marriage & Family Therapist		No
12	251S00000X	Community/Behavioral Health		No
13	261QM0850X	Clinic/Center	Adult Mental Health	No
14	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
15	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30004842030001	MEDICAID	KANSAS
2	30004830030002	MEDICAID	KANSAS
3	363LP0808X	OTHER	KANSAS	TAXONOMY

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »