Revision Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REVISION WELLNESS LLC

Practice address

1317 Edgewater Dr Ste 1501
Orlando, FL 32804-6350

Phone

(407) 755-7034

NPI assigned

Jan 23, 2024

Organization subpart

No

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

Authorized official

Name

Nicole Scovile, LMHC

Title

Owner

Phone

(407) 755-7034

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Nicole Diemond Scovil, LMHC

  • Mental Health Counselor
  • Orlando, FL
  • NPI 1376178699
  Medicare reassignment NPD

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1114789468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WHEELER RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327037410",
            "telephone_number": "407-755-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR STE 1501",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "telephone_number": "407-755-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVISION WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "SCOVILE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-755-7034",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teri Reuter, MA, MA, NCC
• Melissa Ann Revard, APRN
• Christopher Michael Revels, DPT, CSCS
• Revibe Therapy PLLC (Revibe Therapy)
• Ingrid Revilla Madrid
• Revitalize Care of Central Florida
• Revitalize Home Healthcare LLC
• Revival Home Support L.L.C
• Revival Home Support L.L.C
• Revive Transitional Care and in Home Primary Medicine, LLC

• Mental Health Counselor in Orlando, FL
• Providers in Orlando, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.