Revitalize Counseling & Consultation Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVITALIZE COUNSELING & CONSULTATION SERVICES

Practice address

610 Isaac Hayes Dr.
Dyersburg, TN 38024

Phone

(901) 569-2823

NPI assigned

Aug 21, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Steven Foster Murphy, LPCNPI 1861270985

Title

President

Phone

(901) 569-2823

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• Steven Foster Murphy

  • Professional Counselor
  • Orangeburg, SC
  • NPI 1861270985
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1053195263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ISAAC HAYES DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243668",
            "telephone_number": "901-569-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ISAAC HAYES DR.",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "901-569-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE COUNSELING & CONSULTATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "FOSTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-569-2823",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.