Revolve Behavioral Health PLLC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

60227 Issued in TX

Legal business name

REVOLVE BEHAVIORAL HEALTH PLLC

Practice address

7405 Cooper LN
Austin, TX 78745-6307

Phone

(512) 588-2368

NPI assigned

Jul 9, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Combs, LMSW

Title

Therapist

Phone

(512) 588-2368

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1499558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1073035374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 BERNSTEIN ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455528",
            "telephone_number": "512-550-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 COOPER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787456307",
            "telephone_number": "512-588-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLVE BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-09",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "512-588-2368",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "TX",
            "license": "60227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60227",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Reyes Performance Institute

• Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.