Revive Family Therapy, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

REVIVE FAMILY THERAPY, LLC

Practice address

805 Farmington Ave Ste 1
West Hartford, CT 06119-1671

Phone

(860) 462-1345

NPI assigned

Jun 26, 2019

Organization subpart

No

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

Authorized official

Name

Rebecca L. Ruitto, LMFT

Title

Owner

Phone

(860) 579-3258

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1154982445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 FARMINGTON AVE STE 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191671",
            "telephone_number": "860-579-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 FARMINGTON AVE STE 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191671",
            "telephone_number": "860-462-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "RUITTO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-579-3258",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca@revivefamilytherapy.com",
            "affiliation": "N",
            "endpointDescription": "g-suite email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "client correspondence",
            "address_1": "805 Farmington Ave Ste 1",
            "city": "West Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061191671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.