Monica Revak, LPC., CADCII

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3856 Issued in OR

Practice address

2210 N Eldorado Ave
Klamath Falls, OR 97601-6418

Phone

(541) 883-1030

Fax

(541) 884-2338

NPI assigned

Aug 26, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Klamath Child and Family Treatment CenterGroup PAC ID 2062642507, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Klamath Child and Family Treatment Center

  • Voluntary or Charitable Agency
  • Klamath Falls, OR
  • NPI 1902830524
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1235362153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016418",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016418",
            "telephone_number": "541-883-1030",
            "fax_number": "541-884-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVAK",
        "first_name": "MONICA",
        "credential": "LPC., CADCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "II-R-28",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235362153",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renewing Strength Counseling LLC
• Donald Charles Renie, DMD
• Teresa Ann Rennick, PMHNP
• Diane Kathleen Restrepo, MSW
• Janay Revak
• Revive Counseling Services LLC
• Devon L Reyes, LMT
• Ladonna Darlene Reyka, FNP-C
• Andora N Reynolds, PSS/CRM
• Anjelene Reynolds

• Mental Health Counselor in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.