Jessica Revell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW023411 Issued in PA

Practice address

1401 S 31St St FL 2
Philadelphia, PA 19146-3506

Phone

(215) 925-2400

NPI assigned

Aug 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greater Philadelphia Health Action Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1205140902
  Medicare reassignment NPD
• Southwestern Mental Health Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Luverne, MN
  • NPI 1487654562
  Medicare reassignment NPD
• Greater Philadelphia Health Action, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1275151607
  NPD
• Greater Philadelphia Health Action, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1427533280
  NPD

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1093328965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SKYVIEW DR",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164121327",
            "telephone_number": "814-490-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "215-925-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165081402",
            "country_code": "US",
            "telephone_number": "814-459-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVELL",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW137073",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW023411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SafeHarbor@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1330 W 26th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165081402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachael Reuvani
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• Dominique Faye Revan, MD
• Revascmedprofessionals PC
• Revere Dental PC
• Karen Elizabeth Revere, M.D.
• Revision Home Care Services LLC
• Revive Health PT LLC
• Revive Therapy Services

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.