Revive Counseling and Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REVIVE COUNSELING AND WELLNESS

Practice address

317 S Eddy St
South Bend, IN 46617-3201

Phone

(219) 379-4362

NPI assigned

Feb 4, 2020

Organization subpart

No

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

Authorized official

Name

April Rowe, LCSWNPI 1407165954

Title

Owner

Phone

(219) 379-4362

Specialties & licenses 4

Addresses

Locations

Practitioners 1

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

• April Rowe, MSW, LCSW

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1407165954
  NPD Authorized official

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1619509080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173201",
            "telephone_number": "219-379-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE COUNSELING AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "ROWE",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-379-4362",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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": true
        },
        {
            "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": [],
    "endpoints": [],
    "other_names": []
}

• McKinzie Reith, BCBA, LBA
• Kiersten Remenih, BSW
• John T Renzi, MD
• Resource Nurse Staffing LLC
• Retina & Vitreous L L C
• Tyler Allen Rex
• Cristina Reyes, MSW
• Reyna Reyes, BSN, RN
• Catherine Reynoso
• Amanda L Rhoades, LCSW

• Mental Health Clinic/Center (Including Community Mental Health Center) in South Bend, IN
• Providers in South Bend, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.