Active NPI
Gilberto Revuelta
- Mental Health Counselor
- Cheyenne, WY
National Provider Identifier
1144794744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PPC-1388
- Practice address
- 4025 Rawlins St
Cheyenne, WY 82001-1900 - Phone
- (307) 426-4797
- NPI assigned
- Jan 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Mental Health Counselor | 101YM0800X | PPC-1388 | WY | Primary |
Addresses
Primary practice location
4025 Rawlins St
Cheyenne, WY 82001-1900
Mailing address
4025 Rawlins St
Cheyenne, WY 82001-1900
Phone (307) 426-4797
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PPC-1388 | WY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1144794744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4025 RAWLINS ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820011900",
"telephone_number": "307-426-4797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 RAWLINS ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820011900",
"telephone_number": "307-426-4797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVUELTA",
"first_name": "GILBERTO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-16",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "PPC-1388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.