Revelations Behavioral Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

REVELATIONS BEHAVIORAL HEALTH LLC

Practice address

2002 Bremo Rd Ste 202a
Richmond, VA 23226-2441

Phone

(804) 264-2963

NPI assigned

Aug 28, 2023

Organization subpart

No

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

Authorized official

Name

Mark Weldler

Title

Manager

Phone

(773) 919-9351

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1689459679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7366 N LINCOLN AVE STE 206",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 BREMO RD STE 202A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262441",
            "telephone_number": "804-264-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATIONS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "WELDLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-919-9351"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Richmond, VA
• Providers in Richmond, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.