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Individual
MR. MICHAEL RUSSELL REVELL
Active
Individual
MR. MICHAEL RUSSELL REVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
60961479
WA
101Y00000X
Counselor
6991
OR
101Y00000X
Counselor
C6991
OR
101Y00000X
Counselor
R6261
OR
101YM0800X
Mental Health Counselor
Primary
C6991
OR
101YM0800X
Mental Health Counselor
R6261
OR
101YP2500X
Professional Counselor
6991
OR
101YP2500X
Professional Counselor
C6991
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/20/2013
Last updated
03/06/2023
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