Revive Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

REVIVE BEHAVIORAL HEALTH, LLC

Practice address

206 S Mulberry St Ste a
Mount Vernon, OH 43050-3331

Phone

(740) 501-4836

NPI assigned

Apr 9, 2025

Organization subpart

No

Name

Jordan R Moore, APRN-CNPNPI 1821651571

Title

Owner

Phone

(740) 501-4836

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

• Jordan Russell Moore

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, OH
  • NPI 1821651571

  OH, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD Authorized official
• Britney McPeek, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, OH
  • NPI 1598466955

  OH, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Jacqueline Jean Pack

  • Social Worker
  • Mount Vernon, OH
  • NPI 1528954120

  OH, Single Specialty

  Medicare reassignment Care Compare group NPD
• Ryan Neal Adams, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, OH
  • NPI 1164201307

  OH

  Medicare reassignment Care Compare group
• Angela Seckman, DNP, PMHNP-BC, CNL

  • Psychiatric/Mental Health Nurse Practitioner
  • Venice, FL
  • NPI 1447709449

  OH, Psychiatric/Mental Health

  Medicare reassignment NPD
• Lauren Sanders, LISW, MSW

  • Clinical Social Worker
  • Mount Vernon, OH
  • NPI 1306626379

  OH

  Medicare reassignment
• Jessica Singrey

  • Professional Counselor
  • Fredericktown, OH
  • NPI 1194065573

  OH

  Medicare reassignment
• Simona Lydia Moore, C.N.P.

  • Family Nurse Practitioner
  • Mount Vernon, OH
  • NPI 1679502181
  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2025.

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1003601220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 SHARP RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MULBERRY ST STE A",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503331",
            "telephone_number": "740-501-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-501-4836",
        "authorized_official_credential": "APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Danielle F Reynolds
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• Ed Rezny, MA, CCC-SLP
• Ricki Lee Rhea
• James Robert Rhinebolt

• All providers in Mount Vernon, OH
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.