Active NPI
Revitalize Counseling Services LLC
- Professional Counselor
- Menasha, WI
National Provider Identifier
1073401295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- REVITALIZE COUNSELING SERVICES LLC
- Practice address
- 1486 Kenwood Dr Ste 101
Menasha, WI 54952-1133 - Phone
- (920) 284-7950
- NPI assigned
- Jun 26, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katherine Jo Saint
- Title
- Owner
- Phone
- (920) 284-7950
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary | ||
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
1486 Kenwood Dr Ste 101
Menasha, WI 54952-1133
Mailing address
1486 Kenwood Dr Ste 101
Menasha, WI 54952-1133
Phone (920) 284-7950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1486 Kenwood Dr
Ste 101
Menasha, WI 54952
Phone (608) 343-7321
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750896000000",
"number": "1073401295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1486 KENWOOD DR STE 101",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521133",
"telephone_number": "920-284-7950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1486 KENWOOD DR STE 101",
"city": "MENASHA",
"state": "WI",
"postal_code": "549521133",
"telephone_number": "920-284-7950"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVITALIZE COUNSELING SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-26",
"last_updated": "2025-06-26",
"certification_date": "2025-06-26",
"status": "A",
"authorized_official_last_name": "SAINT",
"authorized_official_first_name": "KATHERINE",
"authorized_official_middle_name": "JO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "920-284-7950"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.