Kelsey Revelo

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

4001 Prince William Pkwy Ste 301
Woodbridge, VA 22192-7667

Phone

(703) 688-8541

NPI assigned

Oct 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Family Mental Health of Virginia, LLC

  • Clinical Social Worker
  • Woodbridge, VA
  • NPI 1962103549
  NPD

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1609695535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 PRINCE WILLIAM PKWY STE 301",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221927667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 PRINCE WILLIAM PKWY STE 301",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221927667",
            "telephone_number": "703-688-8541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELO",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Restorative Balance Counseling and Consulting, LLC
• Restorative Health Associates, LLC
• Revamp Physical Therapy
• Revamp Support Residential Services LLP
• Revcare DME Solutions LLC
• Reverence and Resilience Direct Care Services
• Revive Aid, LLC
• Lynda Gabriela Reyes
• Madeline Reyes, M.D.
• Sylvia Sierra Reyes

• Social Worker in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.