| Revive Therapy Llc | |
|
405 Public Sq Ste 350 Troy OH 45373-5200 | |
| (937) 980-3252 | |
| Not Available |
| Full Name | Revive Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 405 Public Sq Ste 350, Troy, Ohio |
| Authorized Official Name and Position | Michelle Ceyler (OWNER/THERAPIST) |
| Authorized Official Contact | 9372163904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Therapy Llc 514 Peters Ave Troy OH 45373-3976 Ph: (937) 216-3904 | Revive Therapy Llc 405 Public Sq Ste 350 Troy OH 45373-5200 Ph: (937) 980-3252 |
| NPI Number | 1497437800 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 08/04/2023 |
| Certification Date | 08/04/2023 |
| Medicare PECOS PAC ID | 8820532807 |
|---|---|
| Medicare Enrollment ID | O20240701003735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497437800 | NPI | - | NPPES |
| 1275087454 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Michelle Ceyler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275087454 PECOS PAC ID: 9739623711 Enrollment ID: I20240702000073 |
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