Revella H Nesbit, LCMHCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3350 Issued in NC

Practice address

9625 David Taylor Drive, Suite 105
Charlotte, NC 28262

Phone

(704) 399-8402

Fax

(704) 392-3586

NPI assigned

Jan 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 1, 2024 through May 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Faith Counseling Center, Inc.

  • Professional Counselor
  • Cornelius, NC
  • NPI 1093941098
  NPD (past) Authorized official

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

{
    "created_epoch": "1136073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1548248495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 AMBER LEIGH WAY DRIVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28269",
            "telephone_number": "704-399-8402",
            "fax_number": "704-392-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 DAVID TAYLOR DRIVE, SUITE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28262",
            "telephone_number": "704-399-8402",
            "fax_number": "704-392-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBIT",
        "first_name": "REVELLA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-01",
        "last_updated": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102253",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neogenix, PC
• Nephrology and Hypertension Consultants,PA
• Nera Care Services LLC
• Shonda Rochelle Nero
• Dominique L Nesbit
• Courtney Leak Nesbitt, LCSW
• Moriah Kathleen Nesbitt, COTA/L
• Rebecca Daughtridge Nesbitt, MS
• Nicole Chiara Schabowski Nesnidal, MD
• Alice Anne Ness, P.T.

• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.