Revive Counseling and Wellness Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REVIVE COUNSELING AND WELLNESS CENTER

Practice address

388 Pleasant St Ste 201a
Malden, MA 02148-8143

Phone

(617) 329-1253

NPI assigned

Oct 9, 2020

Organization subpart

No

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

Authorized official

Name

Lucia N Morales, LICSW

Title

Psychotherapist

Phone

(617) 329-1253

Specialties & licenses 7

Addresses

Other identifiers 2

Locations

Practitioners 3

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

• Kerlie Merizier

  • Mental Health Counselor
  • Malden, MA
  • NPI 1851054522
  NPD
• Sasha Busby, MED

  • Clinical Social Worker
  • Framingham, MA
  • NPI 1952767261
  NPD (past)
• Mary Ann Thomas

  • Mental Health Counselor
  • Malden, MA
  • NPI 1124302492
  NPD (past)

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1558969840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 KENNARD ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021486013",
            "telephone_number": "617-329-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 PLEASANT ST STE 201A",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021488143",
            "telephone_number": "617-329-1253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 Boylston St # 900",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021163305",
            "country_code": "US",
            "telephone_number": "617-329-1253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE COUNSELING AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "617-329-1253",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH SERVICES",
            "identifier": "1134532146",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134532146",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Refined Wellness and Physical Therapy LLC
• Daniela Lizbeth Regalado
• Warren Curtis Reid, BA
• Leah Reidy, PT, DPT
• Natalia Restrepo
• Prona Nakubulwa Rex, BSN
• Cari Reynolds
• Paola M Rhodes, BA
• Sonnly Ribourg, PA
• Brianna Kymarie Riccio

• Clinical Social Worker in Malden, MA
• Providers in Malden, MA by specialty
• Clinical Social Worker in Massachusetts

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