Revolution Youth Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REVOLUTION YOUTH INC

Practice address

95 College St
Burlington, VT 05401-8426

Phone

(207) 812-6070

NPI assigned

Jan 7, 2022

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Savannah Lord, LICSW, LADCNPI 1861080210

Title

Director of Clinical Services

Phone

(207) 812-6070

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Savannah Lord

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1861080210
  NPD Authorized official
• Meghan Laskowski, LICSW, LADC

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1699533992
  NPD (past)

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1619638905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLLEGE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLEGE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018426",
            "telephone_number": "207-812-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION YOUTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "SAVANNAH",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "207-812-6070",
        "authorized_official_credential": "LICSW, LADC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Marie Rembetsy-Brown, DO
• Renascent Laboratories LLC
• Allen Bowman Repp II, M.D.
• David Charles Rettew, M.D.
• Julie D Reville, MS CCCSLP
• Miguel Alberto Reyes-Zaragoza, MD
• Collin Reynolds, DO
• Cynthia D Reynolds, PA
• Katie Reynolds, LICSW
• Kristina Reynolds, CNM, RN

• Community/Behavioral Health Agency in Burlington, VT
• Providers in Burlington, VT by specialty
• Community/Behavioral Health Agency in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.