NPIMap

Organization Active NPI

Revive Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montgomery Village, MD
National Provider Identifier
1003567348
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
REVIVE COUNSELING SERVICES, LLC
Practice address
8701 Tryal CT
Montgomery Village, MD 20886-4362
Phone
(301) 787-2049
NPI assigned
Jan 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Denise McCollin-Twyman, LCSW-CNPI 1164797049
Title
Employee
Phone
(301) 787-2049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

8701 Tryal CT
Montgomery Village, MD 20886-4362

Mailing address

8701 Tryal CT
Montgomery Village, MD 20886-4362
Phone (301) 787-2049

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1003567348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 TRYAL CT",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208864362",
            "telephone_number": "301-787-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 TRYAL CT",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208864362",
            "telephone_number": "301-787-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "MCCOLLIN-TWYMAN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "301-787-2049",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery Village, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.