Revitalize Counseling & Consultation Services is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in Dyersburg, Tennessee. The current practice location for Revitalize Counseling & Consultation Services is 610 Isaac Hayes Dr., Dyersburg, Tennessee. For appointments, you can reach them via phone at (901) 569-2823. The mailing address for Revitalize Counseling & Consultation Services is 610 Isaac Hayes Dr, Dyersburg, Tennessee and phone number is (901) 569-2823.
Revitalize Counseling & Consultation Services is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1053195263. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (901) 569-2823.
Yes. This clinic participates in medicare program and accept medicare insurance.
Mailing Address and Practice Location
Mailing Address
Practice Location Address
Revitalize Counseling & Consultation Services 610 Isaac Hayes Dr Dyersburg TN 38024-3668 Ph: (901) 569-2823
Revitalize Counseling & Consultation Services 610 Isaac Hayes Dr. Dyersburg TN 38024 Ph: (901) 569-2823
NPI Details:
NPI Number
1053195263
Provider Enumeration Date
08/21/2023
Last Update Date
03/28/2024
Certification Date
03/28/2024
Medicare PECOS Information:
Medicare PECOS PAC ID
6608217344
Medicare Enrollment ID
O20240513003493
Medical Identifiers
Medical identifiers for Revitalize Counseling & Consultation Services such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier
Type
State
Issuer
1053195263
NPI
-
NPPES
Medical Taxonomies and Licenses
Taxonomy
Type
License (State)
Status
101Y00000X
Counselor
(* (Not Available))
Secondary
251B00000X
Case Management
(* (Not Available))
Secondary
251S00000X
Community/behavioral Health
(* (Not Available))
Secondary
252Y00000X
Early Intervention Provider Agency
(* (Not Available))
Secondary
261QP2400X
Clinic/center - Prison Health
(* (Not Available))
Secondary
261QM0801X
Clinic/center - Mental Health (including Community Mental Health Center)
(* (Not Available))
Primary
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Revitalize Counseling & Consultation Services acts as a billing entity for following providers:
Wellness Ambulatory Care Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 640 Us Highway 51 Byp E Ste M, Dyersburg, TN 38024 Phone: 731-285-6535 Fax: 731-285-6532
Phoenix Health And Wellness Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1505 Woodlawn Ave Ste A, Dyersburg, TN 38024 Phone: 731-478-6064 Fax: 731-478-6067