NPIMap

Organization Active NPI

Koann Therapeutic Services Inc

Doing business as Revive Therapeutic Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Providence, RI
National Provider Identifier
1629861224
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
KOANN THERAPEUTIC SERVICES INC
Doing business as
Revive Therapeutic Services
Practice address
845 N Main St Ste L1B
Providence, RI 02904-5775
Phone
(401) 648-7172
NPI assigned
May 27, 2025
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KOANN THERAPEUTIC SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Akos AntwiNPI 1760966436
Title
Ceo
Phone
(401) 648-7172

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

845 N Main St Ste L1B
Providence, RI 02904-5775

Mailing address

PO Box 3085
Pawtucket, RI 02861-0585
Phone (401) 648-7172

Other names 1

  • Revive Therapeutic Services Doing business as

National Provider Directory

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

Other organizations with this tax ID 1

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

Locations

845 N Main St
Ste L1B
Providence, RI 02904
Phone (401) 648-7172

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1629861224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3085",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028610585",
            "telephone_number": "401-648-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MAIN ST STE L1B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045775",
            "telephone_number": "401-648-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOANN THERAPEUTIC SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOANN THERAPEUTIC SERVICES INC",
        "enumeration_date": "2025-05-27",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "ANTWI",
        "authorized_official_first_name": "AKOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-648-7172"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Therapeutic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; 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.