| Revenaugh Counseling Llc | |
|
26003 Pink Myrtle Cir Richmond TX 77406-1732 | |
| (832) 759-5999 | |
| Not Available |
| Full Name | Revenaugh Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 26003 Pink Myrtle Cir, Richmond, Texas |
| Authorized Official Name and Position | Robert Lee Revenaugh (OWNER) |
| Authorized Official Contact | 2817349072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revenaugh Counseling Llc 26003 Pink Myrtle Cir Richmond TX 77406-1732 Ph: () - | Revenaugh Counseling Llc 26003 Pink Myrtle Cir Richmond TX 77406-1732 Ph: (832) 759-5999 |
| NPI Number | 1942920590 |
|---|---|
| Provider Enumeration Date | 09/01/2022 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Medicare PECOS PAC ID | 8820536014 |
|---|---|
| Medicare Enrollment ID | O20240820000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942920590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Robert Lee Revenaugh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699428029 PECOS PAC ID: 9739627928 Enrollment ID: I20240820000445 |
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