Revitalize and Restore Therapy

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

REVITALIZE AND RESTORE THERAPY

Doing business as

Rachael Jordan

Practice address

12515 Meridian E Ste 203
Puyallup, WA 98373-3436

Phone

(253) 693-8588

NPI assigned

Jun 18, 2025

Last updated

Jun 18, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rachael Nadyne Jordan, LMHC

Title

Licensed Provider, Owner

Phone

(253) 693-8588

Specialties & licenses 1

Addresses

Other names 1

• Rachael Jordan Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rachael Nadyne Dicecco

  • Mental Health Counselor
  • Puyallup, WA
  • NPI 1023325396
  NPD

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

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1780571380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12515 MERIDIAN E STE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733436",
            "telephone_number": "253-693-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12515 MERIDIAN E STE 203",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733436",
            "telephone_number": "253-693-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE AND RESTORE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "NADYNE",
        "authorized_official_title_or_position": "LICENSED PROVIDER, OWNER",
        "authorized_official_telephone_number": "253-693-8588",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rachael Jordan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dawn Michelle Resvick, LICSW
• Ret Sunrise Physical Therapy, PLLC
• Lise S. Retailliau, D.O.
• Reilly Elizabeth Retz, DPT
• Revera (Delaware) LLC (Linden Grove Health Care Center)
• Nikolaas Enrique Reyna, DDS
• Levi Reynolds, DDS
• Nancy Reynolds, RN
• Rhonda Rayleen Rhoades, MA, LMHC, CTMH
• Kelcey P Rhodes, DDS

• Mental Health Counselor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.