| Revive Counseling Associates | |
|
480 Pierce St Ste 108 Kingston PA 18704-5512 | |
| (570) 262-4788 | |
| Not Available |
| Full Name | Revive Counseling Associates |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 480 Pierce St Ste 108, Kingston, Pennsylvania |
| Authorized Official Name and Position | Brian Cook (MEMBER) |
| Authorized Official Contact | 5702624788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Counseling Associates 480 Pierce St Ste 108 Kingston PA 18704-5512 Ph: (570) 262-4788 | Revive Counseling Associates 480 Pierce St Ste 108 Kingston PA 18704-5512 Ph: (570) 262-4788 |
| NPI Number | 1821665191 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 08/02/2021 |
| Certification Date | 08/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821665191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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