NPIMap

Organization Active NPI

Revive and Thrive Relational Therapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marysville, WA
National Provider Identifier
1215689393
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
REVIVE AND THRIVE RELATIONAL THERAPY PLLC
Practice address
6109 55TH Ave NE
Marysville, WA 98270-4107
Phone
(425) 350-2188
NPI assigned
Jan 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Authorized official

Name
Cassandra Wilson, MA, LMFTNPI 1003278763
Title
Owner
Phone
(425) 477-9115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6109 55TH Ave NE
Marysville, WA 98270-4107

Mailing address

6109 55TH Ave NE
Marysville, WA 98270-4107
Phone (425) 350-2188

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1215689393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6109 55TH AVE NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704107",
            "telephone_number": "425-350-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 55TH AVE NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704107",
            "telephone_number": "425-350-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE AND THRIVE RELATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-477-9115",
        "authorized_official_credential": "MA, LMFT"
    },
    "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": []
}

Other providers in Marysville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.