Revival Psychiatry and Wellness Services, LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Finksburg, MD
NPI 1033085535 · NPPES record last updated Jan 15, 2026
Key facts
- NPI
- 1033085535
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- REVIVAL PSYCHIATRY AND WELLNESS SERVICES, LLC
- Practice address
- 2059 Baltimore Blvd Ste B
Finksburg, MD 21048-1301 - Phone
- (443) 410-6131
- Fax
- (410) 941-2766
- NPI assigned
- Oct 13, 2025
- Organization subpart
- No
Authorized official
- Name
- Maria N Mbeboh, NP
- Title
- Owner
- Phone
- (443) 410-6131
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260505000960 | MD | Part B Supplier - Clinic/Group Practice | 8729556154 |
Receives reassigned benefits from 1 practitioner Practice locations: Finksburg, MD |
National Provider Directory
Locations
2059 Baltimore Blvd
Ste B
Finksburg, MD 21048
Phone (443) 410-6131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
2059 Baltimore Blvd Ste B
Finksburg, MD 21048-1301
Mailing address
2059 Baltimore Blvd Ste B
Finksburg, MD 21048-1301
Phone (443) 410-6131
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 4434106131 | Health Information Exchange (HIE) |
Other providers in Finksburg, MD
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- Linda Marie Rands
- Zachary Philip Rhoten
- Robert Lamar Rice
- Robert B Kroopnick MD Facp PLLC
- Margaret Munsell Roberts
- Barbara Anne Sandusky
All providers in Finksburg, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.