NPIMap

Organization Active NPI

Revive Counseling Spokane, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
National Provider Identifier
1316477805
Registry record updated Mar 24, 2024
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 COUNSELING SPOKANE, PLLC
Practice address
901 N Monroe St Ste 200
Spokane, WA 99201-2148
Phone
(509) 413-2950
Fax
(509) 241-1866
NPI assigned
Jun 15, 2017
Last updated
Mar 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2024

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

Authorized official

Name
Ms. Layne E Pavey, LICSWNPI 1225556483
Title
Owner/MHP
Phone
(509) 413-2950

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

901 N Monroe St Ste 200
Spokane, WA 99201-2148

Mailing address

2222 N Monroe St
Spokane, WA 99205-4545
Phone (509) 413-2950

Other identifiers 4

IdentifierTypeStateIssuer
2079260MedicaidWA
1225556483MedicaidWA
1700304920MedicaidWA
1679873368MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201130003100 WA Part B Supplier - Clinic/Group Practice 7719398510 Receives reassigned benefits from 11 practitioners
Practice locations: Spokane, WA

National Provider Directory

National Provider Directory
Tax ID family
Revive Counseling Spokane PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

901 N Monroe St
Spokane, WA 99201
Phone (509) 413-2950

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711238400000",
    "number": "1316477805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N MONROE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054545",
            "telephone_number": "509-413-2950",
            "fax_number": "509-241-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-413-2950",
            "fax_number": "509-241-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE COUNSELING SPOKANE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2024-03-24",
        "certification_date": "2024-03-24",
        "status": "A",
        "authorized_official_last_name": "PAVEY",
        "authorized_official_first_name": "LAYNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/MHP",
        "authorized_official_telephone_number": "509-413-2950",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2079260",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225556483",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700304920",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679873368",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.