Organization Active NPI

Reviving Wellness Counseling

  • Professional Counselor
  • Virginia Beach, VA
National Provider Identifier
1104287804
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004008 Issued in VA
Legal business name
REVIVING WELLNESS COUNSELING
Practice address
3630 S Plaza TRL Ste 150a
Virginia Beach, VA 23452-3371
Phone
(757) 373-5128
Fax
(757) 431-0700
NPI assigned
Mar 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Mrs. Tina Robin Curran-Taylor, LPCNPI 1700958188
Title
Practice Owner
Phone
(757) 373-5128

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 0701004008 VA Primary

Addresses

Primary practice location

3630 S Plaza TRL Ste 150a
Virginia Beach, VA 23452-3371

Mailing address

3630 S Plaza TRL Ste 150a
Virginia Beach, VA 23452-3371
Phone (757) 373-5128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250319000354 VA Part B Supplier - Clinic/Group Practice 0143742288 Receives reassigned benefits from 2 practitioners
Practice locations: Virginia Beach, VA; Charlottesville, VA

National Provider Directory

National Provider Directory

Locations

250 W Main St
Ste 101
Charlottesvle, VA 22902
Phone (434) 466-2453

3630 S Plaza Trl
Ste 150A
Virginia Beach, VA 23452
Phone (757) 373-5128

4356 Bonney Rd
Bldg 1
Virginia Beach, VA 23452
Phone (757) 962-2326

Practitioners & affiliated clinicians

Practitioners 4

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": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1104287804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 S PLAZA TRL STE 150A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523371",
            "telephone_number": "757-373-5128",
            "fax_number": "757-431-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 S PLAZA TRL STE 150A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234523371",
            "telephone_number": "757-373-5128",
            "fax_number": "757-431-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVING WELLNESS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-09",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "CURRAN-TAYLOR",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "757-373-5128",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.