Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
REVIVE & THRIVE MENTAL HEALTH, LLC
Active
Organization
REVIVE & THRIVE MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANGELINE NEWSOM (OWNER)
(316) 201-6294
Entity
Organization
Contact information
Practice address
4013 N RIDGE RD STE 110, WICHITA, KS 67205-8859
(316) 631-2454
(316) 247-6062
Mailing address
4013 N RIDGE RD STE 110, WICHITA, KS 67205-8859
(316) 201-6294
(316) 364-3020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004830030002
—
KS
05
—
30004842030001
—
KS
01
—
363LP0808X
TAXONOMY
KS
Enumeration date
10/13/2021
Last updated
07/07/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up