Revital Health Care Services LLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Legal business name

REVITAL HEALTH CARE SERVICES LLC

Practice address

1629 K St NW Ste 300NW
Washington, DC 20006-1602

Phone

(571) 365-1833

NPI assigned

Oct 31, 2024

Organization subpart

No

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

Authorized official

Name

Emmanuel Nde, PHARMD

Title

Officer

Phone

(571) 365-1833

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1861214645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 K ST NW STE 300NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 K ST NW STE 300NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061602",
            "telephone_number": "571-365-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Annapolis Rd Ste B5",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207062078",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Annapolis Rd Ste B5",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207062078",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 K St NW Ste 300Nw",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061602",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 K St NW Ste 300Nw",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061602",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 K St NW Ste 300Nw",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061602",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Annapolis Rd",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207062060",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVITAL HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "NDE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "571-365-1833",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rettke, LICSW; LCSW-C
• Shannon Retureta, PHARMD
• Joshua Reuss, MD
• Susan Reuter
• Mary Ellen V Revenis, MD
• Thomas Jacob Revitte, PHARMD
• Revive Clinic LLC
• Revolution Medicine Health & Fitness PLLC
• Revolutionary Care LLC
• Olga Evgenyevna Revzina

• Intellectual & Developmental Disabilities Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Intellectual & Developmental Disabilities Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.