Active NPI
Rachael Lark Revelle
- Mental Health Counselor
- Durham, NC
National Provider Identifier
1710248760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P007253
- Practice address
- 2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829 - Phone
- (919) 251-9001
- Fax
- (919) 251-9008
- NPI assigned
- Jun 6, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P007253 | NC | Primary |
Addresses
Primary practice location
2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Mailing address
2670 Durham Chapel Hill Blvd
Durham, NC 27707-2829
Phone (919) 251-9001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P007253 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1710248760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2670 DURHAM CHAPEL HILL BLVD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277072829",
"telephone_number": "919-251-9001",
"fax_number": "919-251-9008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2670 DURHAM CHAPEL HILL BLVD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277072829",
"telephone_number": "919-251-9001",
"fax_number": "919-251-9008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVELLE",
"first_name": "RACHAEL",
"middle_name": "LARK",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-06",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "P007253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.