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Organization
REVIVE WELLNESS GROUP, LLC
Active
Organization
REVIVE WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEIGHYA J RICHARD LMHC (OWNER/LICENSED PSYCHOTHERAPIST)
(407) 250-7831
Entity
Organization
Contact information
Practice address
2647 NARNIA WAY UNIT 102, LAND O LAKES, FL 34638-7270
(407) 250-7831
Mailing address
2647 NARNIA WAY UNIT 102, LAND O LAKES, FL 34638-7270
(407) 250-7831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/15/2019
Last updated
06/05/2023
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