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Organization
REVIVE COUNSELING AND WELLNESS CENTER
Active
Organization
REVIVE COUNSELING AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIA N MORALES LICSW (PSYCHOTHERAPIST)
(617) 329-1253
Entity
Organization
Contact information
Practice address
388 PLEASANT ST STE 201A, MALDEN, MA 02148-8143
(617) 329-1253
Mailing address
36 KENNARD ST, MALDEN, MA 02148-6013
(617) 329-1253
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134532146
MENTAL HEALTH SERVICES
MA
05
—
1134532146
—
MA
Enumeration date
10/09/2020
Last updated
10/09/2020
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