NPIMap

Organization Active NPI

Revitalize LLC

Doing business as Revitalize Counseling Center

  • Mental Health Counselor
  • Spring Hill, FL
National Provider Identifier
1508649955
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
REVITALIZE LLC
Doing business as
Revitalize Counseling Center
Practice address
6149 Deltona Blvd
Spring Hill, FL 34606-1000
Phone
(352) 606-0323
NPI assigned
Aug 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Dory Richards, LMFT
Title
Owner
Phone
(352) 606-0323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

6149 Deltona Blvd
Spring Hill, FL 34606-1000

Mailing address

6149 Deltona Blvd
Spring Hill, FL 34606-1000
Phone (352) 606-0323

Other names 1

  • Revitalize Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

6149 Deltona Blvd
Spring Hill, FL 34606
Phone (352) 428-5235

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1508649955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6149 DELTONA BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061000",
            "telephone_number": "352-606-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6149 DELTONA BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061000",
            "telephone_number": "352-606-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "DORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-606-0323",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.