Revive Relationship Therapy Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.01099 Issued in IL

Legal business name

REVIVE RELATIONSHIP THERAPY INC.

Practice address

1967 N Dayton St
Chicago, IL 60614

Phone

(312) 714-5168

NPI assigned

Jul 21, 2017

Organization subpart

No

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

Authorized official

Name

Amanda BerryNPI 1205379484

Title

Owner

Phone

(312) 714-5168

Specialties & licenses 1

Addresses

Practitioners 2

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

• Amanda Lauren Berry

  • Marriage & Family Therapist
  • Chicago, IL
  • NPI 1205379484
  NPD (past) Authorized official
• Rachel Lehr, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
  • NPI 1497313316
  NPD (past)

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366965394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 W WEBSTER AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143140",
            "telephone_number": "312-714-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 N DAYTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "312-714-5168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1952 N Fremont St",
            "address_2": "Coachhouse",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60614",
            "country_code": "US",
            "telephone_number": "312-714-5168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "939 W North Ave Ste 750",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606427142",
            "country_code": "US",
            "telephone_number": "312-714-5168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE RELATIONSHIP THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-714-5168"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.01099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yelena M Revich, D.D.S.
• Revital Chiropractic & Wellness PLLC
• Revitalize IV Solutions, LLC
• Revival Therapy & Wellness Inc
• Revive Chiropractic
• Gadi Asher Revivo, D.O.
• Revolution Counseling and Wellness LLC
• Revolution Health Systems
• Revolution Physical Therapy Weight Loss
• Revolution PTWL LLC

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.