Courage on Purpose

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COURAGE ON PURPOSE

Practice address

2473 S Higley Rd # 104-124
Gilbert, AZ 85295-1103

Phone

(602) 491-5928

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Omar J Reveron

Title

Director of Services

Phone

(904) 415-5993

Specialties & licenses 1

Addresses

Practitioners 1

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

• Erica Reveron, LAC

  • Mental Health Counselor
  • Gilbert, AZ
  • NPI 1871125724
  NPD

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1275388985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2473 S HIGLEY RD # 104-124",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951103",
            "telephone_number": "904-415-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2473 S HIGLEY RD # 104-124",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951103",
            "telephone_number": "602-491-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE ON PURPOSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "REVERON",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF SERVICES",
        "authorized_official_telephone_number": "904-415-5993",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Stefan Costinean, M.D.
• Jordan Blaine Coulston, M.D
• Lacey Courchaine, NMD
• Alisha Marie Courtney, FNP-C
• Stephanie Morgan Courvisier, APRN, AGNP-C
• Meagan Coveney, MOT
• Jacob M. Cover, PT

• Mental Health Counselor in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.