Revelation of Hope Counseling Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2865 Issued in TN

Legal business name

REVELATION OF HOPE COUNSELING SERVICES, LLC

Practice address

384 Carriage House Dr Ste C
Jackson, TN 38305-2268

Phone

(731) 868-7297

Fax

(877) 273-4824

NPI assigned

Jul 2, 2014

Organization subpart

No

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

Authorized official

Name

Alvin G. Bonds IINPI 1073871331

Title

Owner & Clinical Director

Phone

(731) 868-7297

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 9

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

• Alvin G. Bonds II, LPC/MHSP

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1073871331
  Medicare reassignment NPD Authorized official
• Melinda Dawn Gordon

  • Professional Counselor
  • Jackson, TN
  • NPI 1093492217
  NPD
• Emma Beth Griswell

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1447035019
  NPD
• Robyn Elizabeth McDaniel, LPC/MHSP (TEMP), NCC

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1003547662
  NPD
• Jamey Moore, MS

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1245919778
  NPD
• Jordan Timothy Northrop

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1861235053
  NPD
• Kristen L Wilson, LPC-MHSP (TEMP), NCC

  • Mental Health Counselor
  • Jackson, TN
  • NPI 1700517299
  NPD
• Nicole Scott Young, LCSW

  • Clinical Social Worker
  • Henderson, TN
  • NPI 1720372253
  NPD (past)
• Carissa Battle, LCSW

  • Clinical Social Worker
  • Winchester, VA
  • NPI 1144615709
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1871909689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383430934",
            "telephone_number": "731-487-3595",
            "fax_number": "877-273-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 CARRIAGE HOUSE DR STE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052268",
            "telephone_number": "731-868-7297",
            "fax_number": "877-273-4824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "386 Carriage House Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052236",
            "country_code": "US",
            "telephone_number": "731-487-3595",
            "fax_number": "877-273-4824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVELATION OF HOPE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "BONDS",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER & CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "731-868-7297",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "2865",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "2865",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "990",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006062",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael Allen Revelle, M.D.
• Kristin Herron Reynolds
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• Mental Health Counselor in Jackson, TN
• Providers in Jackson, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.