Revive & Thrive Mental Health, Llc

LBN: Revive & Thrive Mental Health, Llc
Revive & Thrive Mental Health, Llc is an health care organization with primary practice located at 4013 N Ridge Rd Ste 110 , Wichita KS 67205-8859. The organization recently has 14 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty. Revive & Thrive Mental Health, Llc can be contacted via phone (316) 631-2454, or through Newsom, Evangeline via phone (316) 201-6294.

Contact Information

Primary practice address
4013 N Ridge Rd Ste 110 Wichita KS 67205-8859
Phone: (316) 631-2454
Fax: (316) 247-6062
Website:
Map and Directions
Authorized official contact:
Name: Newsom, Evangeline
Phone: (316) 201-6294

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1356003628
LBN Legal business name Revive & Thrive Mental Health, Llc
DBA Doing business as
Authorized official Newsom, Evangeline
Entity Organization
Organization subpart 1 No
Enumeration date Oct 13th, 2021
Last updated Jul 7th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356003628 NPPES
Kansas MEDICAID 30004830030002
Kansas Other 363LP0808X
Kansas MEDICAID 30004842030001

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