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REVIVE COUNSELING AND WELLNESS CENTER NPI 1558969840


NPI Information

NPI: 1558969840
Provider Name: REVIVE COUNSELING AND WELLNESS CENTER
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
388 PLEASANT ST STE 201A
MALDEN, MA
ZIP 02148
Phone: (617) 329-1253
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REVIVE COUNSELING AND WELLNESS CENTER is a clinical social worker in Malden, MA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. REVIVE COUNSELING AND WELLNESS CENTER NPI is 1558969840. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

388 PLEASANT ST STE 201A
MALDEN, MA
ZIP 02148-143
Phone: (617) 329-1253

The provider's authorized official is Lucia N Morales .
The authorized official title is Psychotherapist and has the following contact phone number (617) 329-1253.

The enumeration date for this NPI number is 10/9/2020 and was last updated on 10/9/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthNo
3261Q00000XClinic/CenterNo
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
5261QM0850XClinic/CenterAdult Mental HealthNo
6261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
71041C0700XSocial WorkerClinicalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11134532146MEDICAIDMASSACHUSETTS
21134532146OTHERMASSACHUSETTSMENTAL HEALTH SERVICES

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

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