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Organization
REVIVE WELLNESS LLC
Active
Organization
REVIVE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MORAES LCSW (DIRECTOR)
(203) 501-4624
Entity
Organization
Contact information
Practice address
81 WISTERIA DR, NAUGATUCK, CT 06770-5235
(203) 501-4624
Mailing address
81 WISTERIA DR, NAUGATUCK, CT 06770-5235
(203) 501-4624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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