Revive Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REVIVE WELLNESS LLC

Doing business as

Revive Wellness

Practice address

802 Bacon St
Pekin, IL 61554-4534

Phone

(309) 219-5057

NPI assigned

Apr 9, 2024

Organization subpart

No

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

Authorized official

Name

Haley B Robbins, LCSWNPI 1821717026

Title

Co/Owner / Therapist

Phone

(309) 219-5057

Specialties & licenses 1

Addresses

Other names 1

• Revive Wellness Doing business as

Practitioners 1

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

• Haley Briana Robbins, LCSW, PMH-C

  • Mental Health Counselor
  • Pekin, IL
  • NPI 1821717026
  NPD Authorized official

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1215780101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 BACON ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544534",
            "telephone_number": "309-219-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 BACON ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544534",
            "telephone_number": "309-219-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "ROBBINS",
        "authorized_official_first_name": "HALEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CO/OWNER / THERAPIST",
        "authorized_official_telephone_number": "309-219-5057",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Justin Reeg
• Sonia Lynne Reeves, APN
• Tracey J Reimer, P. T.
• Eric Vincent Reinertson, M. D.
• Susan Rettig, CRNA
• Dustin Rewinkel
• Jeannie Ann Reynolds
• RHC Investments, LLC - Pekin Operations Series
• Caterina Nicole Richardson, LICENSED CLINICAL PR
• Jonathan Rider, N.P.

• Mental Health Counselor in Pekin, IL
• Providers in Pekin, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.