NPIMap

Organization Active NPI

Revival Therapy Services LLC

  • Mental Health Counselor
  • Colorado Springs, CO
National Provider Identifier
1619780145
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
REVIVAL THERAPY SERVICES LLC
Practice address
3520 Austin Bluffs Pkwy Ste 101
Colorado Springs, CO 80918-5756
Phone
(303) 551-0117
Fax
(303) 551-0117
NPI assigned
Jan 29, 2025
Organization subpart
Yes
Parent organization
REVIVAL THERAPY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Sacha LacasseNPI 1326504630
Title
Owner/Director
Phone
(720) 441-4622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3520 Austin Bluffs Pkwy Ste 101
Colorado Springs, CO 80918-5756

Mailing address

1133 N Pennsylvania St
Denver, CO 80203-2502
Phone (303) 551-0017

National Provider Directory

National Provider Directory
Tax ID family
Revival Therapy Services2 organizations share this tax ID, including this one
Part of
Revival Therapy Services

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3520 Austin Bluffs Pkwy
Ste 101
Colorado Springs, CO 80918
Phone (303) 551-0117

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1619780145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 N PENNSYLVANIA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802032502",
            "telephone_number": "303-551-0017",
            "fax_number": "303-551-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 AUSTIN BLUFFS PKWY STE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185756",
            "telephone_number": "303-551-0117",
            "fax_number": "303-551-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL THERAPY SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REVIVAL THERAPY SERVICES",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "LACASSE",
        "authorized_official_first_name": "SACHA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "720-441-4622"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.