Revisit Play, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REVISIT PLAY, LLC

Practice address

1140 S Morton St
Bloomington, IN 47403-4744

Phone

(812) 727-4922

NPI assigned

Sep 19, 2025

Organization subpart

No

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

Authorized official

Name

Whitney Sullivan, LCSW, RDT/BCTNPI 1356689939

Title

Rendering Provider

Phone

(812) 727-4922

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Whitney E Sullivan, LCSW, RDT

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1356689939
  NPD Authorized official

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

{
    "created_epoch": "1758240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1740152644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1424",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021424",
            "telephone_number": "812-727-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S MORTON ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034744",
            "telephone_number": "812-727-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVISIT PLAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "RENDERING PROVIDER",
        "authorized_official_telephone_number": "812-727-4922",
        "authorized_official_credential": "LCSW, RDT/BCT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Dean Rensberger, M.S., LCSW
• Corinna Repetto, MD
• Jamie L Resseguie
• Deborah Ann Reutter, LCSW
• Ronit L Reuveny, CNM, FNP-C
• Andrea Lynne Reynolds, RN
• Nader Rezvan, MD
• Rheumatology Center of Southern Indiana
• Carl Rhinehart III
• Stanley Milton Rice, PAC

• Clinical Social Worker in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.