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REVIVAL COUNSELING SERVICES INCORPORATED NPI 1831647213


NPI Information

NPI: 1831647213
Provider Name: REVIVAL COUNSELING SERVICES INCORPORATED
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
5357 CHAPEL HILL RD
DOUGLASVILLE, GA
ZIP 30135
Phone: (770) 942-4742
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REVIVAL COUNSELING SERVICES INCORPORATED is a clinical social worker in Douglasville, GA. 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. REVIVAL COUNSELING SERVICES INCORPORATED NPI is 1831647213. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5357 CHAPEL HILL RD
DOUGLASVILLE, GA
ZIP 30135-027
Phone: (770) 942-4742

The provider's authorized official is Danielle Bonich .
The authorized official title is Sole Proprietor/owner and has the following contact phone number (678) 656-8249.

The enumeration date for this NPI number is 9/14/2016 and was last updated on 9/14/2016.


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
11041C0700XSocial 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14829878OTHERGEORGIACIGNA

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: 5/5/2024

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