Organization Active NPI

Revenir Counseling and Wellness, PLLC

  • Mental Health Counselor
  • Austin, TX
National Provider Identifier
1407343759
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
71606 Issued in TX
Legal business name
REVENIR COUNSELING AND WELLNESS, PLLC
Practice address
4131 Spicewood Springs Rd Ste H2
Austin, TX 78759
Phone
(901) 262-4577
Fax
(855) 765-7552
NPI assigned
Apr 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Authorized official

Name
Dixon J. Parnell, LPC
Title
Owner/Sole Practitioner
Phone
(901) 262-4577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 71606 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd Ste H2
Austin, TX 78759

Mailing address

4131 Spicewood Springs Rd Ste H2
Austin, TX 78759-8659
Phone (901) 262-4577

Other identifiers 1

IdentifierTypeStateIssuer
71606OtherTXTEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS

National Provider Directory

National Provider Directory

Locations

4131 Spicewood Springs Rd
Ste H2
Austin, TX 78759
Phone (512) 343-1560

NPI Registry JSON

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1407343759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE H2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598659",
            "telephone_number": "901-262-4577",
            "fax_number": "855-765-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE H2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "901-262-4577",
            "fax_number": "855-765-7552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVENIR COUNSELING AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-21",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "PARNELL",
        "authorized_official_first_name": "DIXON",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/SOLE PRACTITIONER",
        "authorized_official_telephone_number": "901-262-4577",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "71606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS",
            "identifier": "71606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.