Revive Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REVIVE PSYCHOTHERAPY LLC

Practice address

21 Eisenhower Ave
Natick, MA 01760-2946

Phone

(978) 905-9609

NPI assigned

Aug 14, 2025

Organization subpart

No

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

Authorized official

Name

Nidhi Jain, LICSWNPI 1194207043

Title

Manager

Phone

(978) 905-9609

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Nidhi Jain

  • Clinical Social Worker
  • Framingham, MA
  • NPI 1194207043
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1699651562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 EISENHOWER AVE",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017602946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EISENHOWER AVE",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017602946",
            "telephone_number": "978-905-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "NIDHI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "978-905-9609",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Natick, MA
• Providers in Natick, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.