Julie D Reville, MS CCCSLP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

068-0000747 Issued in VT

Practice address

2 Church St
Suite 4G
Burlington, VT 05401-4299

Phone

(802) 734-0777

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1033237581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST",
            "address_2": "SUITE 4G",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014299",
            "telephone_number": "802-734-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST",
            "address_2": "SUITE 4G",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014299",
            "telephone_number": "802-734-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILLE",
        "first_name": "JULIE",
        "middle_name": "D",
        "credential": "MS CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "01038597",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0000747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "4149910",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00049731",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David Charles Rettew, M.D.
• Revolution Youth Inc
• Miguel Alberto Reyes-Zaragoza, MD
• Collin Reynolds, DO
• Cynthia D Reynolds, PA
• Katie Reynolds, LICSW

• Mental Health Counselor in Burlington, VT
• Providers in Burlington, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.