Peaceful Revolution LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PEACEFUL REVOLUTION LLC

Doing business as

Own Your Colors Counseling

Practice address

4414 Centerview Ste 273
San Antonio, TX 78228-1405

Phone

(210) 764-7767

Fax

(210) 764-7767

NPI assigned

Aug 19, 2019

Last updated

May 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Natalie Jean Burtenshaw, LCSW

Title

Therapist and Business Owner

Phone

(210) 764-7767

Specialties & licenses 1

Addresses

Other names 1

• Own Your Colors Counseling Doing business as

Locations

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588982400000",
    "number": "1396392924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 CENTERVIEW STE 273",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281405",
            "telephone_number": "210-764-7767",
            "fax_number": "210-764-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 CENTERVIEW STE 273",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281405",
            "telephone_number": "210-764-7767",
            "fax_number": "210-764-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL REVOLUTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-19",
        "last_updated": "2020-05-09",
        "certification_date": "2020-05-09",
        "status": "A",
        "authorized_official_last_name": "BURTENSHAW",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "THERAPIST AND BUSINESS OWNER",
        "authorized_official_telephone_number": "210-764-7767",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Own Your Colors Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2020; 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.