Revive and Thrive Mental Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVIVE AND THRIVE MENTAL WELLNESS

Practice address

8435 Progress Dr Ste FF
Frederick, MD 21701-4981

Phone

(301) 682-2047

Fax

(301) 644-3308

NPI assigned

Feb 7, 2020

Organization subpart

No

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

Authorized official

Name

Gloria Corbin

Title

Director of Finance

Phone

(301) 732-6300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1144852187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8435 PROGRESS DR STE FF",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014981",
            "telephone_number": "301-682-2047",
            "fax_number": "301-644-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 PROGRESS DR STE FF",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014981",
            "telephone_number": "301-682-2047",
            "fax_number": "301-644-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE AND THRIVE MENTAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "301-732-6300"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Frederick, MD
• Providers in Frederick, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.