The Revival Room, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE REVIVAL ROOM, LLC

Practice address

301 N Spring St Ste 130
Bellefonte, PA 16823-1543

Phone

(814) 343-1533

Fax

(888) 253-1993

NPI assigned

Apr 1, 2026

Organization subpart

No

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

Authorized official

Name

Jaycie Jabco, LPCNPI 1851936488

Title

Licensed Professional Counselor

Phone

(717) 487-8857

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.

• Jaycie Jabco, LPC

  • Mental Health Counselor
  • Clarence, PA
  • NPI 1851936488
  NPD Authorized official

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1760323265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N SPRING ST STE 130",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168231543",
            "telephone_number": "814-343-1533",
            "fax_number": "888-253-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N SPRING ST STE 130",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168231543",
            "telephone_number": "814-343-1533",
            "fax_number": "888-253-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REVIVAL ROOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "JABCO",
        "authorized_official_first_name": "JAYCIE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "717-487-8857",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bellefonte, PA
• Providers in Bellefonte, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.