Revive Counseling Center LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

REVIVE COUNSELING CENTER LLC

Practice address

11535 Park Woods Cir Ste C
Alpharetta, GA 30005-4490

Phone

(833) 221-4169

NPI assigned

Dec 4, 2025

Organization subpart

No

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

Authorized official

Name

Azar MemarzadehNPI 1588427603

Title

President

Phone

(833) 221-4169

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Azar Memarzadeh, MS NCC LPC

  • Mental Health Counselor
  • Alpharetta, GA
  • NPI 1588427603
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1764806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1972466282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 PARK WOODS CIR STE C",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11535 PARK WOODS CIR STE C",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054490",
            "telephone_number": "833-221-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "MEMARZADEH",
        "authorized_official_first_name": "AZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-221-4169"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.