| Revitalize Counseling, Pllc | |
|
431 Waterville Rd Realeigh NC 27603 | |
| (919) 357-8832 | |
| (919) 336-5134 |
| Full Name | Revitalize Counseling, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 431 Waterville Rd, Realeigh, North Carolina |
| Authorized Official Name and Position | Ashley Craft (OWNER) |
| Authorized Official Contact | 9193578832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalize Counseling, Pllc 1220 Timber Dr E # 1033 Garner NC 27529-6917 Ph: () - | Revitalize Counseling, Pllc 431 Waterville Rd Realeigh NC 27603 Ph: (919) 357-8832 |
| NPI Number | 1700544350 |
|---|---|
| Provider Enumeration Date | 12/01/2021 |
| Last Update Date | 12/01/2021 |
| Certification Date | 11/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700544350 | NPI | - | NPPES |
| C012367 | Other | NC | LCSW |
| 1447727607 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |