Revive Therapy & Wellness PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVIVE THERAPY & WELLNESS PLLC

Practice address

4721 N Woodlawn LN
Spokane Valley, WA 99216-2384

Phone

(509) 936-3357

NPI assigned

Jan 21, 2025

Last updated

Jan 21, 2025By 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

Elezaveta Mikheyeva, MSW, LICSWNPI 1437637154

Title

Clinical Social Worker

Phone

(509) 936-3357

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, and the practitioner matching its NPPES authorized official.

• Elezaveta Y Mikheyeva, MSW LICSW

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1437637154
  NPD Authorized official

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1396557930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 N WOODLAWN LN",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162384",
            "telephone_number": "509-936-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 N WOODLAWN LN",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162384",
            "telephone_number": "509-936-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE THERAPY & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "MIKHEYEVA",
        "authorized_official_first_name": "ELEZAVETA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "509-936-3357",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather M. Renz, LMP
• Stacie Repsold
• Res-Care Washington, Inc. (ResCare Home Care)
• Restorative Touch
• Restoring Hope Spokane, PLLC
• Clay Reyes
• Tayjha Reyes
• Andrew Jay Reynolds, PHARMD
• Jamie Reynolds
• Katherine Elizabeth Reynolds, ARNP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.