Revive & Thrive Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05485900 Issued in NJ

Legal business name

REVIVE & THRIVE THERAPY LLC

Practice address

173 E Grant Ave
Roselle Park, NJ 07204-2026

Phone

(908) 315-5947

Fax

(908) 344-5537

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Arlene Vieira Anjos, LCSW

Title

Member

Phone

(908) 315-5947

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1205217809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 E GRANT AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042026",
            "telephone_number": "908-315-5947",
            "fax_number": "908-344-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 E GRANT AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042026",
            "telephone_number": "908-315-5947",
            "fax_number": "908-344-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE & THRIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "ANJOS",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "VIEIRA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "908-315-5947",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05485900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Roselle Park, NJ
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• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.